PATIENT SAFETY IN CASES OF ILEOSTOMY AFTER SURGERY FOR LOW RECTAL CANCER

In the contemporary coloproctology, mini-invasive surgery appears to be fully safe and feasible approach in cases with distal rectal cancer. Benefits of this type of operations have been already proven. However laparoscopic surgery has its disadvantages as reduced tactility and limited working space. These can be some of the factors leading to the decision of creating an ileostomy in the end while performing this type of operations. Studies about the influence of the ileostomy regarding the perioperative complications after surgery for distal rectal cancer, are still going on. In contemporary literature there is no one standpoint for the safety of this kind of procedures and if it leads to reduction of the frequency of anastomosis insufficiency and the mortality for low rectal resections. Purpose of our research is to examine the safety and feasibility of the ileostomy during surgical treatment for distal rectal cancer.In the present abstract we examined the period from June 2012 to December 2015 for operated patients for distal rectal cancer in the Surgical Department of UMHAT ―Eurohospital Plovdiv‖. For the mentioned period 80 patients were operated. The cases of low rectal resections with provisional ileostomy were 57. We performed laparoscopic interventions in 34 of the cases. The main criteria we used for analyzing the received data were: early and late anastomosis-related complications, complications of the ileostomy and length of the hospital stay. We think that in well selected patients, forming an ileostomy after low anterior rectal resection, can be fully safe procedure. We suggest this method for patients with distal rectal cancer and for these after neoadjuvant therapy. Forming a provisional ileostomy leads to considerable reduction of reoperation frequency and complications in cases of anastomotic leak