METHOD FOR IMPOSING A DOUBLE-BARRELED ILEOSTOMY WHEN PERFORMING LAPAROSCOPIC RIGHT-SIDED HEMICOLECTOMY WITH A LATERO-MEDIAL APPROACH IN PATIENTS WITH COLON CANCER COMPLICATED BY ACUTE INTESTINAL OBSTRUCTION

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, namely to colorectal surgery and oncology. At the first stage, the unloading double-barreled ileostomy is placed on the anterior abdominal wall in the middle of the rectus abdominis muscle 3-4 cm below the edge of the costal arch in the projection of the transverse colon with a discharge loop up to 15 cm long, located on the right, and a leading loop on the left. At the second stage, the ileostomy is sutured with interrupted sutures, laparoscopic ports are installed. The latero-medial approach mobilizes the right sections of the colon. A section of the intestine carrying the stoma is isolated and immersed in the abdominal cavity. Temporary sutures are applied to the wound of the anterior abdominal wall through all layers. After mobilization, the right sections with the tumor are resected and removed through the ileostomal wound on the anterior abdominal wall. Through the same wound, the stump of the ileum and transverse colon is brought out to the anterior abdominal wall and anastomosis is applied extracorporeally.;EFFECT: method allows patients with colorectal cancer complicated by acute obstruction performing decompression, prepare the patient for the radical stage of video-laparoscopic access, expose the mesentery with vessels in the projection of the transverse colon and along the right sections of the colon to perform the radical stage using video-laparoscopic latero-medial technologies access to use the ileostomal wound to remove the resected section of the intestine with the tumor and extracorporeally apply a small-colon anastomosis.;1 cl, 1 dwg