Tactics of surgical treatment of complications of abdominal-perineal extirpation of the rectum in a patient with locally advanced cancer against the background of combined treatment of the progression of the process. Clinical observation

The paper presents a clinical case related to the implementation of a surgical step-by-step method of treating a patient with malignant rectal formation, progression of the underlying disease, against the background of a paravesical abscess in the pelvis, after previously comprehensive treatment. The tactics of therapeutic measures consisted, at the first stage, in the rehabilitation of the pelvis, the resolution of a paravesical abscess, followed by simultaneous excision of the soft tissues of the perineum, resection of the ileum, the formation of enteroenteroanastomosis, the formation of a heterotopic urinary reservoir according to Bricker, plasty of the defect of the perineum with a VRAM flap. An important condition for the implementation of the treatment plan is to conduct an interdisciplinary consultation with the involvement of specialists of various profiles, which is aimed at resolving the oncological process and complications of its treatment.