| Abstract [eng] |
The Ph.D. theses are submitted for defence as a set of research articles and some parts have been quoted verbatim from the previously published articles listed at the end of the book. The dissertation consists of several parts, which are all connected. First, we performed a retrospective analysis to identify the risk factors and the rate of anastomotic leakage and long-term outcomes. Moreover, anastomotic leakage rate and outcomes were compared between the elderly and non-elderly patients with left-sided colorectal cancer who underwent resection with primary anastomosis. After that, a meta-analysis was performed to analyse the impact of various intraoperative mechanical integrity and bowel perfusion tests. Also, we designed the experimental study focused on mechanical integrity testing and compared air-leak and methylene blue leak tests. Parallelly, the prospective study was performed for patients undergoing left-sided colorectal surgery with primary anastomosis. The bowel blood perfusion, tension, and mechanical integrity were checked by various tests which helped us to identify high-risk colorectal anastomosis. Preventive ileostomy was created for the majority of these patients. A novel idea has been born, how to replace ileostomy creation in high-risk anastomoses. Total parenteral nutrition was suggested as an alternative method for preventive ileostomy creation. |
