Search

Results of treatment of 204 elderly and senile patients who underwent cystprostatectomy or anterior pelvic exenteration are analyzed. A comparative analysis of two groups of patients whose operation ended with the traditional drainage through the anterior abdominal wall (n = 100), and bilateral perineal drainage (n = 104) is presented. Bilateral perineal drainage after operations on the pelvic organs, accompanied by cystectomy and extended lymphadenectomy in conjunction with the restoration of the peritoneum lateral pelvic walls, improves postoperative recovery of intestinal peristalsis, promotes an earlier reduction in the intensity of pain and morbidity in the early postoperative period. Perineal installation of drains is a simple in design and safe procedure. We recommend bilateral perineal drainage after operations on the pelvic organs, accompanied by cystectomy and extended lymphadenectomy.

A total of 1436 patients with colorectal cancer underwent resective surgery: 244 (15.6%) received combined interventions, 94 (41.9%) pelvic exenteration (PE), 38 (40.4%) complete PE, 9 (9.6%) of which were infralevator and 29 (30.8%) supralevator. In 56 (59.6%) patients posterior PE was performed, supralevator was performed in 17 (18.1%) cases and infralevator in 39 (41.5%) cases. In 47 (69.1%) of 68 supralevator PE recipients colonic anastomosis was formed. In 21 (38.9%) patients a terminal colostoma was formed, in 29 (76.3%) of 38 patients incontinent urinary diversion was formed. Continent urinary diversion was performed in 9 (23.7%) patients. Twenty six (27.6%) patients had 43 post-operative complications which were lethal in 7 (26.9%) cases.

The present study is devoted to improving quality of life of patients in elderly and senile age after operation of Bricker by finding the optimal method of forming ureterointestinal anastomosis. From 2007 to 2009 103 patients of elderly and senile age with diseases requiring removal of the bladder were treated in the Lenigrad Regional Oncology Centre. All the patients were made cystectomy. Patients were divided into two groups: In 1st group, the ureterointestinal anastomosis was formed a classical way "end to side" described Bricker, in the 2nd group ureterointestinal anastomosis was performed by the method of Wallace - "common area". Pathological conditions developed in patients in late postoperative period were as follows: hydronephrosis in early and later stages, obstructive pyelonephritis, frequent attacks of chronic pyelonephritis, chronic renal failure, urinary fistula. Formation of ureterointestinal anastomosis by Wallace during surgery reduces the amount of later postoperative complications. Quality of life was better after the formation of ureterointestinal anastomosis by Wallace.

Examination of 65 postmenopausal women with urinary incontinence demonstrated that most of the patients had mixed urinary incontinence. Pathogenesis of urinary incontinence in postmenopausal women is strongly associated with estrogen deficiency. This dictates necessity of preoperative hormone replacement therapy. Surgical treatment of postmenopausal women aims at elevation of obturator pressure, prolongation of the urethra with narrowing of its orifice which can be managed with combination of urethrocystoplasty, levatoroplasty and sling operation.