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Authors represent the surgical technique of colectomy with preserving the natural intestinal passage in the treatment of the familial colic adenomatosis. The technique is based on the preserving the distal part of the rectum with its demucosation and connecting with the ileal conduit. The rectal mucosa reconstruction is performed with the use of allogenic transplantation of fetal intestinal cells. 27 patients were operated on. The rectal mucosa reconstruction was registered in all cases range 4-12 weeks postoperatively. The long-term follow-up showed no disease recurrence within 5 years. The method demonstrated better intermediate and long-term functional results.

Thirty-five autopsied specimens of rectum's distal part and anal canal part were studied. It was revealed that length of physiological hypogangliosis zone ranged from 7.5 to 50.0 mm (mean 24.4+/-10.9 mm). With regard to this wide range the modification of transanal Svenson's biopsy of rectal wall was proposed for diagnosis of malformations of intramural nervous system of the colon. The method was used in 21 patients with megacolon. The results demonstrate accuracy and safety of this diagnostic method.

Experience in the treatment of 118 patients with nonepithelial new growths of the rectum has been accumulated at the Scientific Research Institute of Proctology in the period from 1970 to 1991. They accounted for 1.5% of all benign and malignant tumors of this organ. Leiomyoma was diagnosed in 44, leiomyosarcoma in 18, lipoma in 30, fibroma in 17, neurinoma in 7 and rhabdomyoma in 2 of these patients. A differential diagnosis was made between benign and malignant tumors, as well as with other nonepithelial new growth of the rectum. On the basis of the clinical picture and the results of digital and instrumental (radiological, endoscopic, and ultrasonic) examination of the rectum the correct preoperative diagnosis may be established with certain probability. This influences directly the choice of the volume of the operative intervention in various types of nonepithelial rectal tumors. Morphological verification of the tumor is the principal method of examination in establishing the differential diagnosis in the preoperative and postoperative periods.

The authors discuss an original method for formation of a smooth-muscle cuff from the wall of a pulled-through colon in the region of a perineal colostoma. It was applied in 89 patients who had undergone extirpation of the rectum for malignant neoplasms. The smooth-muscle sphincter was formed during removal of the rectum in 72 patients and no earlier than 2 years after the extirpation in 17 patients. Inflammatory complications developed in the region of the perineal colostoa in the early postoperative period in 13.5% of cases. They were due to necrosis of the distal part of the pulled-through intestine in 3.4% of cases. There were no fatal outcomes. The late-term results were studied in follow-up periods of up to 7.5 years. Satisfactory functional results were produced in 83% of the patients. Physiological examination showed the presence of a functioning sphincter in the region of the perineal colostoma.

From analysis of the surgical treatment of 36 patients with rectal leiomyoma the authors suggest and substantiate the indications for various types of operative interventions according to the size and location of the tumor. The late-term results of the treatment were studied in all patients who underwent surgery and a brief review of literature on the methods of diagnosis and surgical management of benign smooth-muscle tumors of the rectum is given.