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Аннотация
Колоректальный рак по своей распространенности занимает одну из лидирующих позиций в структуре онкологических заболеваний, при этом на долю рака прямой кишки приходится более трети всех случаев. Оперативное лечение, включающее этап тотальной мезоректумэктомии, в комбинации с неоадъювантной лучевой терапией является стандартом лечения средне- и нижнеампулярного рака прямой кишки. По данным литературы, до 90 % пациентов, перенесших переднюю резекцию прямой кишки, сообщают о различных проявлениях дисфункции кишечника в послеоперационном периоде, объединенных в синдром низкой передней резекции. Выраженность функциональных расстройств при данном синдроме варьируется по степени тяжести и оценивается по шкале LARS, при этом тяжесть синдрома коррелирует со снижением качества жизни пациентов. Основными этиологическими факторами развития являются нарушение иннервации сфинктера и механическое его повреждение. Лечение синдрома низкой передней резекции принято разделять на 3 линии — от консервативной терапии и терапии биологической обратной связи до стимуляции крестцового нерва, и выведении постоянной колостомы при рефрактерности к лечению в течении двух лет и более.
Библиографические ссылки
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