ILEOPROCTOSTOMY (Latin ileum ileal gut + grech, proktos rectum + stoma of companies, opening, pass; synonym: ileorektalny anastomosis, ileoproctostomy) — operation of imposing of an anastomosis between an ileal gut and a straight line. Unlike ileosigmostomiya (see) at And. an anastomosis impose lower than the level of the sacral cape (promontorium) for what will mobilize a proximal part of an ampoule of a rectum, previously having tied up an upper pryamokishechny artery.
This operation is applied as the second stage after removal of all colon concerning diffusion a polypose or multiple tumors, nonspecific ulcer colitis, etc. Sometimes And. the polypose is carried out as the first stage of operational treatment diffusion. In this case the colectomy is made in the second stage.
Technology of operationStaplers ), however their use at the expressed cicatricial and inflammatory changes of a wall of a rectum is inexpedient. In these cases the manual seam certainly is preferable (see. Intestinal seam ) as less traumatic and allowing to adapt selectively fabrics according to features of their changes on a circle of the created anastomosis. Operation comes to an end with immersion of an anastomosis under a pelvic peritoneum after drainage of retrorectal space through counteropening on a crotch and carrying out through an anus above an anastomosis of a soft rubber tube for removal of gases and intestinal contents.
From postoperative complications insufficiency of seams of an anastomosis with development of phlegmon of pelvic cellulose and peritonitis is most dangerous. In the presence of the drainage tube brought to a zone of an anastomosis through counteropening on a crotch it is possible to diagnose and treat timely this complication. At emergence from a drainage tube of pus and intestinal contents imposing of a double-barreled ileostoma is reasonable. It unloads an anastomosis, promotes elimination of inflammatory process in pelvic cellulose and to healing of defect of an anastomosis.
At a favorable postoperative current at patients with And. gradually (within 2 — 3 months) the number of defecations is reduced to 4 — 5 times a day, and the kcal gains kashitseobrazny character.
Bibliography: Vasilyev A. A. Clinic and surgical treatment of nonspecific ulcer colitis, M., 1967, bibliogr.; P and in to and V. L. N and d river. Polyps and diffusion polyposes of direct and thick guts, M., 1969, bibliogr.; Yudin I. Yu. Nonspecific ulcer colitis, L., 1968, bibliogr.; G about 1 i f? h e of of J. Page of Surgery of the anus, rectum and colon, L., 1975.
V. D. Fedorov.