Introducere. Aplicarea anastomozelor colorectale, de regula, in cura neoplaziilor colorectale, reprezinta un avansat risc pentru dehiscenta anastomotica, ce in mare parte cauzeaza si o letalitate alarmanta. Scopul lucrarii. Aprecierea tacticii medico-chirurgicale optime in dehiscentile anastomotice pe fondal de rezectii colorectale. Material si metode. In studiul dat au fost inclusi 156 pacienti care au fost supusi rezectiei colorectale cu anastomoza primara. Printre cauzele acestor rezectii, clar au dominat, neoplaziile colonice si rectale – 71,4%. Cu scop de prevenire a dehiscentei anastomotice 24 (15,38%) de pacienți au profitat de o ileostoma de protectie. Dehiscenta anastomotica a fost inregistrata in 14 (8,97%) cazuri. In lotul celor cu ileostoma de protectie aceasta complicatie nu s-a inregistrat. Evolitie grava a fost fixata la pacientii cu dehiscente aparute pina la 6 zile de la rezectia aplicata. Toti acesti pacienti au fost supusi relaparatomiei cu drenarea focarului septic si colostomie. Letalitatea postoperatorie a constituit 3,84% (6 pacienti), printre care s-au numarat 2 cazuri de dehiscenta. Concluzii. Pacientii cu dehiscenta anastomotica aparuta la scurt timp de la interventie (mai putin de 6 zile) au necesitat obligatoriu relaparatomie cu colostomie / ileostomie si lavajul cavitatii peritoneale. La intervale ce depaseau 6 zile tactica curativa a fost una individuala, in conformitate cu particularitatile evolutive ale procesului septic (monitoring clinic, ultrasonor, tomografic si de laborator).

Introduction. The application of colorectal anastomoses, as a rule, in the treatment of colorectal neoplasms is an advanced risk for anastomotic dehiscence, which largely causes an alarming lethality. The purpose of the study. Appreciation of the optimal medico-surgical tactics in the dehiscence of the colorectal anastomoses. Material and methods. The study included 156 patients who underwent colorectal resection with primary anastomosis. Among the causes of these resections, colon and rectal neoplasms clearly dominated - 71.4%. In order to prevent anastomotic dehiscence, 24 (15.38%) patients took advantage of a protective ileostomy. The anastomotic dehiscence was recorded in 14 (8.97%) cases. In the group of those with the protective ileostomy, this complication was not registered. Severe evolution was noticed in patients with dehiscence within 6 days from the application. All of these patients underwent relaparotomy with septic drainage and colostomy. The postoperative lethality constituted 3.84% (6 patients) among which were two cases of dehiscence. Conclusions. Patients with anastomotic dehiscence that appeared shortly after the intervention (less than 6 days) required mandatory relaparotomy with colostomy / ileostomy and lavage of the peritoneal cavity. At intervals exceeding 6 days, the curative tactic was an individual one, in accordance with the evolutionary peculiarities of the septic process (clinical, ultrasound, tomographic and laboratory monitoring).