[Optimal methods of rehabilitation of patients after a left-side colostomy].

Unlabelled: Annually one million new cases of colorectal cancer (CRC) are detected worldwide. During 1967-2008 standardized rate of morbidity with large intestine cancer in Georgia has increased from 4.43%00 to 15.3%00. More than 70% of patients visit the hospitals with neglected forms of disease. Issues of early diagnosis of CRC and reliable detection of pre-tumor villose neoplasms and polyps of large intestine still remain of current importance. Program of "risk groups" screening proved to be most effective measure for prevention of CRC and its complications.

Purpose Of The Study: expediency of the rational methods of screening and improvement of outcomes of surgical rehabilitation of patients with temporary left colostomas. Material of the study consisted of 572 observations, grouped into three "risk groups", where the program uses the developed and improved algorithm applying the following tests: questioning, survey, test on occult bleeding, sigmoidoscopy, colonoscopy with endobiopsy, irrigography, ultrasound investigation, bacteriological investigation based on the data of computer tomography and nuclear-magnetic resonance. In total 163 (28,4%) cases of different pathologies of large intestine have been detected. Among them 48 (8,4%) patients with pre-tumor processes and 10 (1,7%) patients with CRC have been detected. Screening of colonoscopy and test on occult bleeding proved high rate of detection among "non-symptomatic" contingent. In clinic the stages for preparation and performing reconstructive surgery while eliminating left colostomas have been developed. Optimal terms of the surgery, pre-operative preparation of intestines, antibacterial correction with Riphaximin, perorally as well as rectally, modification of technical elements of the operation have been specified in the clinic. 87 reconstructive interventions on elimination of left colostomas have been performed.

Outcomes: no lethal cases, festering - 4 patients, illeofemoral thrombosis - 1 patient, that didn't require additional surgical interventions. The study found that Alfa-Normiks (Riphaximin) reduces the frequency of complications in post-operative period.