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The OBJECTIVE to analyze the available researches over the past 5 years and systematized the main groups of factors, which leading to the leakages of colonic anastomoses after resection and reconstructive procedures. Literature analysis was carried in the medical databases PubMed, Medline, Cochrane Library, Web of Science. 22 randomized trials and meta-analyses were included in the literature review. All researches investigated large sample of patients presented and the number of factors evaluated with statistically significant reliability. We analyzed and presented the controlled and uncontrolled factors, which were leading to leakages of colonic anastomoses after reconstructive and resection procedures at different stages of treatment of this category of patients. The frequency of the development of the leakages of interstitial anastomoses according to the studied literature is high. Evaluation of proven factors in the preoperative period will in most cases reduce the risks and, as a consequence, the frequency of leakages of colonic anastomoses. This will be significantly improved to the results of treatment of coloproctological patients.

The OBJECTIVE of the study was to assess the possibility of using laser technologies in the treatment of perianal Crohn’s disease.METHODS AND MATERIALS. The study included 18 patients with perianal Crohn’s disease who were treated in Surgery Department ¹ 3 of the Clinic of the Research Institute of Surgery and Emergency Medicine of Pavlov University. The study was conducted in 2 stages. The first stage consisted in placing the draining seton (ligature) in the main fistulous canal. The second stage was performed in 3 months. The seton was removed with further laser destruction of the fistulous canal. On the background of surgical treatment, the patients received conservative therapy according to the recommendations of gastroenterologists.RESULTS. Every stage of surgical treatment lasted no more than 30 minutes, under intravenous anesthesia. Intraoperative blood loss did not exceed 5 ml. Due to the absence of complications, the bed-day of each stage varied from 0 to 2 days. 3 months after surgical treatment, the examination showed the complete closure of the fistula canals. The maximum period of relapse-free course was 24 months. All patients received anti-inflammatory therapy, 63 % of patients continued to receive genetically engineered biological therapy.CONCLUSION. The use of sphincter-preserving techniques proved to be effective in patients with perianal Crohn’s disease. It improves the quality of life and reduces the risk of patients’ disablement.

An observation from practice was devoted to the experience of an interdisciplinary approach in the diagnosis and surgical treatment of a patient with complicated course of Crohn’s disease against the background of the formation of a stricture of the terminal ileum, an enterovesical fistula, the penetration into the mesentery of the sigmoid colon.

Radiation proctitis is a rare and significant complication of the combined therapy in patients with pelvic cancer. The choice of treatment of chronic radiation proctitis depends on the stage of disease and recurrent rectal bleeding. Comorbidity is cause to complicated proctitis. These clinical cases describe the choice and sequence of surgical interventions in order to achieve successful results in patients with chronic radiation proctitis.