An original surgical method for the formation of fascial duplication in the elimination of damage to the anterior rectal wall during prostatectomy

Abstract

Background. Intraoperative rectal injury in patients undergoing prostatectomy is a severe complication, worsens the quality of life and leads to social maladjustment.Objective. To develop, substantiate the reproducibility and safety of the technique for the formation of fascial duplication in the elimination of damage to the anterior rectal wall during prostatectomy.Materials and methods. The authors present a description of the technique and their own experience of retropubic prostatectomy with the formation of fascial duplication in the elimination of damage to the anterior rectal wall in 2 patients with prostate cancer. Patients with intermediate risk of recurrence and progression according to the D'Amico index. The observation period is 6 and 11 months.Results. Prostatectomy revealed damage to the anterior rectal wall and destruction of the external longitudinal muscular layer of the rectum. The rectal defect was eliminated according to the original method. The duration of the operation is 160 and 140 min. Intraoperative blood loss 350 and 150 ml. The first bowel movement on the 5th day. Removal of the urethral catheter on day 10. The period of hospitalization was 11 and 14 days, no postoperative mortality was noted. No lethal outcomes were noted.Conclusion. A constructively simple surgical technique for the formation of fascial duplication by local tissues in case of intraoperative injury of the rectum during prostatectomy has been developed and implemented into clinical practice.