The differentiated way of forming preventive stomas in surgery of the rectal cancer

The material for the present research becomes retrospective results of 319 patients with rectal cancer who were operated in the departments of military-medical surgery, general surgery of Military-Medical Academy named after S.M. Kirov for the period from 2003 year till present time. The preventive stoma at 25 (7,8%) patients from 319 was formed according different indications: the impossibility of appropriate pre surgical preparation of the large bowel because of constrictive growth, the intention of proximal part of the large bowel after forming the hardware anastomic leakage. In all periods of monitoring, the operation was finished by draining of the presacral space from a side of the perineum and if it is possible to regenerate the wholeness of the pelvic peritoneum higher than a line of the anastomic leakage. This method lets us lower the risk of the expansion of the peritonitus at the anastomic leakage and gives the opportunity to treat this complication by non-surgical therapy. The anastomic leakage at the patients without protective stoma appeared at 14 (4,7%) from 294 operated patients, and only in 2 (0,6%) cases the relaporotomy was needed to solve the problem of the anastomic leakage. In all the other cases the event of the anastomic leakage was solved with a help of non-surgical therapy.