Surgical correction of functional disorders in performing sphincterosafing operations for rectal cancer (literature review)

Abstract

For many decades the main goal of oncologists was to increase life expectancy of patients with malignant tumors, without paying due attention to quality of life. Currently, the goals of patients’ treatment with rectal cancer are to cure, to minimize the risk of local recurrence, preserve the normal course of intestine, to optimize it's function and to ensure quality of life. For a long time, the standard surgical treatment of patients with low rectal cancer was abdominoperineal extirpation, but recently sphincterosafing operations have seen a widespread introduction in surgical practice. However, functional results after these types of operations don't always meet the expectations of surgeons and patients. In the postoperative period, patients often develop a syndrome of low anterior resection, characterized by frequent bowel movements, repeated, prolonged and incomplete evacuation of bowel and the imperative urge to defecate. The manifestation of this syndrome can significantly impair the quality of patient's life and reduce to nothing the efforts of the surgeon to preserve the sphincter of the rectum. For surgical correction of low anterior resection syndrome, various types of colonic reservoir anastomoses have been proposed. The purpose of formation of colonic reservoirs is to increase the cumulative function of intestine. However, the existing methods have several disadvantages related to technical complications and the risk of developing evacuation dysfunction, which is the reason for search the new ways of optimization of anastomoses when performing sphincterotomy operations for cancer of the rectum.