Background Colon cancer (CC) one of the most common oncological disease in World. Up to 30% patients in Russia have metastatic CC at first visiting to oncologist. The treatment results still controversial. Nowadays, minimally invasive laparoscopic precision technique allowed extending the indication for cytoreductive surgery even in patients with severe comorbidities. Materials and methods 89 patients with colon cancer (T1-4a) and curable synchronous distant metastases include in study. All patients underwent cytoreductive surgery with primary tumor resection. In study group (44) we performed laparoscopic surgery, in main group (45) – open surgery procedure. The groups were similar by sex, age, tumor localization and histological structure, comorbidities. Results R0 resection performed 27% patients. The average number of lymph node removal was similar 13 and 12 respectively. Average operation time was significantly longer in study group 210 vs 120 min. In study group blood loss was lower: 300 mL vs 1200 mL. Postoperative patient recovery shorter after laparoscopic surgery (p < 0.05): time to activation 2.2 vs 3.9 days; time to first peristalsis – 1.8 vs 4.5 days; first bowel movement – 3.4 vs 4.8 days; first food taken – 2.9 vs 3.9 days. Shorter time of analgesics intake – 2.3 vs 4.4 days, p < 0.05. Hospital stay shorter: 9.3 vs 13.4 days, p = 0.05. Time to start chemotherapy reduced since 27.5 to 14.7 days, p < 0.05. Postoperative complications lower in study group: 6.8 vs 17.8%, p = 0.05. Kaplan–Meier 2-year overall survival were similar: 69.5% vs 61.6%, p = 0.96. Conclusion Laparoscopic cytoreductive surgery for metastatic CC is safe, minimized surgical trauma and speed up patient recovery.

The first colproctrectomy with the formation of a pelvic intestinal reservoir was performed in 1970. Since then, the technique has been thoroughly tested and currently it is the gold standard in the surgical treatment of ulcerative colitis and familial adenomatous polyposis. This operation allows to improve the quality of patients’ life, reducing the need to form a permanent ileostomy, improving the psychomotional, social and physical rehabilitation of patients. However, this intervention is associated with a high risk of postoperative complications. Impairment of the the pelvic reservoir functioning, as well as the addition of infection, are terrible complications that significantly worsen the patient’s quality of life. Surgeons performing this type of surgery have to face a number of intraoperative and postoperative complications that require repeated interventions. The aim of the study is to improve the results of treatment of patients with the small bowel reservoir. A review and analysis of the literature is performed in this issue. Successful results of performing colproctectomy with the formation of a pelvic enteric reservoir depend on careful preoperative planning, experience of the surgeon, prevention of intra‑ and postoperative complications.

Rectal fistula – one of the most common coloproctological diseases. Annually, thousands of patients with anal fistula have had treated around the world. Treatment of this disease is an actual problem in coloproctology nowadays due to the high frequency of recurrence and anal incontinency. The chronic persistent perianal suppuration and multiple surgical interventions the main predictor of emergence of the anal incontinence, which could be achieve almost 50 %, according the literature data. The risk of emergence the anal incontinence is particularly high in the treatment of complex fistulas. Therefore, the problem of complex rectal fistulas treating remains an actual task in the clinical practice of a coloproctologist.

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