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FAP is an autosomal dominant disorder characterized by the appearance of thousands of adenomatous polyps. FAP is associated with a deletion of chromosome 5q21 (known as the APC gene). Surgical prophylaxis in FAP consists of resection of the entire large bowel, to prevent malignant transformation. Hereditary Nonpolyposis Colorectal Cancer(HNPCC), like FAP, is an autosomal dominant disorder. In contrast to FAP, HNPCC is associated with an unusually high frequency of cancers in the proximal large bowel. If an adenoma or adenocarcinoma of the colon is identified, total abdominal colectomy with an ileorectal anastomosis is recommended.

Ischemic colitis is the most common form of intestinal ischemia. The damage produces ulcers in the lining of the large intestine. Ischemic colitis affects primarily people who are 50 or older. The disease was first described by Boley and associates [1] as a "reversible vascular occlusion" of the colon, and Marston and colleagues [2] went on to detail the gangrenous, stricturing, and transient forms. Two mechanisms may cause bowel ischemia: The first and most common is diminished bowel perfusion due to low cardiac output often seen with in patients with cardiac disease or in prolonged shock of any etiology. The second mechanism is occlusive disease of the vascular supply of bowel due to atheroma, thrombosis, or embolism in which the collateral circulation is not adequate to maintain bowel integrity.

Large intestinal obstruction like a life-threatening steatement is a subject of investigation in the present study. In such prospection are included 65 patients undergone surgery for large intestinal obstruction of cancer in period of seven years. Analyzed are after undertaken surgical procedures. It is clear that tendency of more security after surgery is concerned with the principles of radicalization after lower morbidity and mortality.

Authors present 28 cases of bowel injuries after blunt abdominal trauma. Patients were from 14 to 71 years of age, 18 (64%) men and 10 (36%) women. The most common cause for the trauma was the car accident--in 18 cases. In the rest 10 the trauma was result of household activities. The small bowel was injured in 16 patients, the large bowel in 9 and in 3--the duodenum. In 15 cases the trauma was only abdominal and in the rest 13 it was accompanied by other traumas. Three of the 28 patients reported herein died.

Transplantation of a free smooth-muscular cuff around a terminal large-intestinal segment, brought out as preternatural anus, secures high-degree continence and controlled evacuatory rhythm of the intestinal content. The preserved structure of the muscular layers in the cuff wall and the myogenic nature of smooth muscle tone are preconditions for functional activity manifestation in conditions of denervation, isolation and even after block of neurons and intramural ganglia. Five preparations comprising the smooth muscle cuff and recipient large-intestinal segment undergo histomorphologic and electromyographic study within a year of transplantation. In a series of 31 patients with drawn out continent preternatural anus the thickness of the abdominal wall together with the smooth muscle cuff graft is echographically registered at the end of the first postoperative year. The echographically documented abdominal wall thickness is compared with the histomorphologically established values of the indicator under study. Analysis of the functional activity of the smooth-muscle-cuff transplant is also done.

The results of perioperative decontamination in a series of 136 patients presenting diseases of the colon and rectum are evaluated. Of the total 74 are subjected to operation according to schedule, and 62 are operated on an emergency basis. Perioperatively, metronidazole plus a cephalosporin antibiotic (cephazolin, cephalothin or cephamandol) are administered. Primary anastomoses are done in 32 cases operated according to schedule, and in fourteen patients operated in the emergency room. Insufficiency of the anastomosis is recorded in 3.5 per cent in the former group, and in 15 per cent in the latter group (p > 0.05). Operative wound suppuration occurs in 5.4 per cent against 13 per cent (p > 0.05), with lethality amounting to 1.3 per cent and 19 per cent, respectively (p < 0.001). Postoperative pneumonia is registered in 4 per cent of those operated on schedule and in 9.6 per cent of those operated by urgency (p > 0.05). In either group there is not a single case of operative wound dehiscence. In colorectal operations antibacterial prophylaxis applied perioperatively proves effective in combating systemic and local inflammatory complications.

A total of 232 patients with obturation ileus, caused by locally advanced colorectal carcinoma, are operated over a 12-year period (1979-1990). In 160 patients (68.97 per cent) the tumor is located in the colon, and in 72 (31.03 per cent)-in the rectum. The operative interventions performed are distributed as follows: 122 (52.58 per cent) radical, and 110 (47.42 per cent) palliative. There are 84 patients (36.03 per cent) in IV clinical stage. Postoperative lethality among those subjected to radical operation amounts to 25.41 per cent, with leading underlying causes-peritonitis (35.08 per cent) and serious ileus intoxication (21.05 per cent). The survival over 1, 3 and 5-year periods among those radically operated is 74.59, 48.37 and 34.06 per cent, respectively. Histologically differentiated adenocarcinoma is demonstrated in 69.38 per cent, undifferentiated-in 17.50 per cent, and mucinous adenocarcinoma-in 13.12 per cent. The factors with a high prognostic value include: stage of primary tumor development, lymph involvement, type of operative intervention and histological variant of the neoplasm.