The results of using necessarily low anterior resections for carcinoma of the lower half of the middle third of the rectum
Dimitrov, V.; Dudunkov, Z.; Ralchev, K.
Khirurgiia 42(3): 98-103
1989
ISSN/ISBN: 0450-2167 PMID: 2677510 Document Number: 346845
Compulsively low anterior resection of rectum was performed in patients with tumor localized in the lower half of the middle one third of the rectum (7-10 cm from the anorectal line) and vague vascular arcades in the left half of the colon or having very fat meso. The following technique was applied: The left half of the colon was mobilized, releasing it from the gastrocolic junction, and the rectum--to the anal sphincters; One-stage anastomosis with step-like course of the catgut was performed, threading it previously to the posterior and lateral parts of the anastomosis and on the anterior wall--to the rectal stump only; when the anastomosis was performed, the catgut was passed through the upper pelvic diaphragmatic fascia as well. The method was applied on 19 patients; the first six of them had prophylactic transversostomy performed. In none of the patients was insufficiency of the anastomosis or recurrence of the tumor observed.