Koloproktologia最新文献

{"title":"Endoscopic mucosal resection with a circumferential incision in the removal of colon neoplasms. Results of a randomized trial.","authors":"E. U. Abdulzhalieva, A. Likutov, V. Veselov, D. Mtvralashvili, O. M. Yugai, E. Khomyakov, S. Chernyshov, O. Sushkov","doi":"10.33878/2073-7556-2024-23-1-21-31","DOIUrl":"https://doi.org/10.33878/2073-7556-2024-23-1-21-31","url":null,"abstract":"OBJECTIVE: to compare the immediate and long-term results of endoscopic mucosal resection with a circular incision (C-EMR) and endoscopic submucosal dissection (ESD) in the treatment of patients with large benign epithelial neoplasms of the colon.PATIENTS AND METHODS: a prospective randomized comparative study was conducted from November 2020 to July 2022, included 103 patients with benign epithelial neoplasms of the colon ranging in size from 20 to 30 mm. The C-EMR method was used in 52, ESD - 51 patients.RESULTS: the removal of the tumor by the C-EMR method required statistically significantly less time, compared with the ESD method – 30 and 60 minutes, respectively (p<0.001). Intra- and postoperative complications occurred in 13(23.7%) patients in the C-EMR group and in 12(23.5%) patients in the ESD group. The most frequently reported complication was postcoagulation syndrome in the main and control groups – in 9(17.3%) and 11(21.6%) cases, respectively. It was found that the difficult location of the tumor (OR=18.3; p=0.01) and intraoperative complications (OR =37.5; p=0.04) are independent conversion factors of endoscopic intervention. The frequency of tumor removal in a en bloc and achievement of negative resection margins (R0) in the main and control groups did not significantly differ – 47(90.4%) and 49(96.1%) (p=0.4) and 40(76.9%) and 45(88.2%) (p=0.2), respectively.CONCLUSION: endoscopic mucosal resection with a circumferential incision is an effective and safe operation comparable to endoscopic submucosal dissection, and can be the method of choice for benign epithelial neoplasms of the colon with sizes from 20 to 30 mm. In addition, the duration of the operation using the C-EMR method is two times less than using ESD.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":"138 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140223697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Сontrolled circular dilatation and lateral subcutaneous sphincterotomy for chronic anal fissures associated with hemorrhoids III-IV","authors":"Z. Z. Kamaeva, A. Y. Titov, R. Y. Khryukin, I. S. Anosov, Y. Shelygin","doi":"10.33878/2073-7556-2024-23-1-42-51","DOIUrl":"https://doi.org/10.33878/2073-7556-2024-23-1-42-51","url":null,"abstract":"","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":" 77","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140221885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of palliative primary tumor resection on overall survival in minimally symptomatic (asymptomatic) colorectal cancer and synchronous unresectable metastases vs chemotherapy only: a comparative study of outcomes","authors":"Iuliia Alimova, S. Achkasov, Y. Shelygin, M. Alekseev, V. Kashnikov, M. Fedyanin, M. A. Danilov, E. G. Rybakov","doi":"10.33878/2073-7556-2023-22-4-10-23","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-4-10-23","url":null,"abstract":"Aim: to evaluate the impact of primary tumor resection (PTR) on treatment outcomes in patients with asymptomatic or minimally symptomatic colorectal cancer (CRC) and synchronous unresectable metastases.Patients and Methods: treatment outcomes of patients with minimally symptomatic CRC and synchronous unresectable metastases were retrospectively assessed (2016–2022). Patients with PTR followed by chemotherapy were compared to patients receiving chemotherapy only. Survival was determined by the Kaplan-Meier method and differences were evaluated using the log-rank test and Cox proportional-hazards regression model. To reduce potential selection bias between two groups a propensity score matching (PSM) was performed.Results: no significant differences in 30-day mortality rate (р = 1,00) and the rate of surgical intervention due to complications of first treatment (р = 1,00) between the two groups. Before matching the median survivals were 27,8 and 24 months in the PTR and chemotherapy groups, respectively (р = 0,2). After PSM the overall survival rate at 3 years was 42,1% for the PTR group and 34% for the chemotherapy group (р = 0,47). The median survivals were 27,9 and 24,4 months, respectively. Three-year overall survival rate for patients with stage IVB was significantly higher in the PTR group than in the chemotherapy group (37,8% versus 4,8%; р = 0,02). The median survivals were 36,1 and 17,2 months, respectively. In multivariate analysis radical resection (R0) if unresectable metastases converted into resectable after initial treatment was the only significant prognostic factor for survival (p < 0,001).Conclusions: PTR in patients with asymptomatic or minimally symptomatic CRC and synchronous unresectable metastases is associated with acceptable postoperative morbidity and mortality rates and may improve overall survival for patients with stage IVB comparing to chemotherapy as a treatment of first line. However, randomized controlled trials are needed.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":"8 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138948323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The first experience of robot-assisted vental mesh rectopexy using the Senhance® system in the treatment of patients with obstructive defecation syndrome","authors":"A. Khitaryan, A. Golovina, K. Veliev, A. Mezhunts, A. Alibekov, A. Orekhov, V. Khitaryan, K. S. Oplimah","doi":"10.33878/2073-7556-2023-22-4-89-98","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-4-89-98","url":null,"abstract":"Aim: to assess primary results of robot-assisted ventral mesh procedure using the new Senhance® robotic system for obstructive defecation syndrome.Patients and Methods: the prospective cohort study included patients who underwent robot-assisted ventral mesh rectopexy with the Senhance® system for obstructive defecation syndrome caused by rectocele and/or rectal prolapse and/or internal intussusception. The optimal trocar sites, the location of robotic arms, operation time and intraoperative blood loss were evaluated, as well as post-op morbidity rate (Clavien-Dindo scale), pain intensity (VAS scale) and recurrence rate.Results: the study included 22 patients. Operation time was 87.1 ± 24.3 minutes. The intraoperative blood loss was 19.8 ± 9.6 ml. No conversion to open or laparoscopic approach occurred, no morbidity occurred. Pain intensity on day 1 was 0.255 mm according to VAS. No anatomical recurrence was revealed. The median follow-up period was 20.4 months (7–22 months).Conclusion: robotic-assisted ventral rectopexy using the Senhance® system is effective and safe. The results are similar to laparoscopic ones. However, the use of the Senhance® system is cost effective compared to other robotic systems.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":"43 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138948885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolism in the large intestine wall after injury of the thoracic spinal cord (experimental study)","authors":"M. Baleev, E. Kiseleva, E. L. Bederina, M. Loginova, M. V. Shirmanova, A. P. Fraerman, V. I. Scheslavsky, N. Gladkova, M. Ryabkov","doi":"10.33878/2073-7556-2023-22-4-24-32","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-4-24-32","url":null,"abstract":"Ailm: to assess metabolic processes in the serous layer of the large intestine in the acute period of spinal injury.Materials and Methods: the experiment was carried out on laboratory animals — Wistar rats (n = 20). Spinal injury was simulated by complete transection of the spinal cord at the level of Th5-Th6 vertebrae. Metabolic changes in the intestinal wall were assessed before injury, 3 and 24 hours after spinal cord transection. Metabolism was assessed in vivo using fluorescence time-resolved macroimaging technology (macroFLIM) by autofluorescence in the spectral channel of the metabolic cofactor NAD(P)H.Results: a significant (p = 0.041) increase in the mean fluorescence lifetime (τm) by 12% and the lifetime of the long component (τ2) of the NAD(P)H cofactor by 13% (p = 0.008) was detected 24 hours after injury. MacroFLIM showed an increase in the intensity of metabolism in the large intestine wall.Conclusion: for the first time in an in vivo experiment, it has been shown that the acute period of spinal injury is accompanied by an increase in metabolic activity in the tissues of the large intestine. The revealed phenomenon confirms the role of the large intestine in compensatory reactions to spinal injury and open up new possibilities for therapy in the acute period of spinal cord injury.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138951125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Granular cell tumor of the perineum (clinical case)","authors":"R. R. Shakirov, O. Karpukhin, M. I. Ziganshin, I. S. Raginov","doi":"10.33878/2073-7556-2023-22-4-121-126","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-4-121-126","url":null,"abstract":"Aim: to present a clinical case of a rare granular cell tumor (Abrikosov’s tumor) with perianal site.Patients and Methods: a patient had a slowly progressive growth of a perianal tumor. The tumor with dimensions of 40 × 30 mm intimately adheres to the lower ampullary rectum and anterior portion of m. levator ani, no signs of malignant transformation occurred. Trepanobiopsy was performed followed by immunohistochemical study. The biopsies contain mainly fibrous tissue and clusters of cells with rounded nuclei and granular cytoplasm. Immunohistochemistry showed diffuse positive cytoplasmic reaction with antibodies to S100. The tumor was positive for CD8, vimentin and negative for GFAP. The expression of the Ki67 protein was 2%. Diagnosis: granulocellular tumor (Abrikosov’s tumor), the tumor was removed by perineal access.Resultss: the removal of the tumor, originating from the low rectum, was performed with perineal access and with the restoration of the muscular layer of the bowel wall. No complications occurred, patient discharged 5 days after surgery.Conclusion: Abrikosov’s tumor is a rare benign neoplasm. Surgery is possible in coloproctological units with sufficient level of surgeons.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":"25 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138951132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of inflammation activity in the small and large bowel using the MaRIAs index for Crohn’s disease","authors":"V. A. Michalchenko, I. Zarodnyuk, D. M. Belov, V. Veselov, B. Nanaeva","doi":"10.33878/2073-7556-2023-22-4-71-79","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-4-71-79","url":null,"abstract":"Aim: to evaluate diagnostic value of magnetic resonance enterocolonography (MR-enterocolonography) with the use of the segmental index MaRIAs (Simplified Magnetic Resonance Index of Activity) for inflammation activity in small and large intestine colon compared with ileocolonoscopy.Patients and Methods: the prospective cohort study included 58 patients with Crohn’s disease aged 19–45 years. All patients underwent MR-enterocolonography with intravenous contrast and ileocolonoscopy. MR-enterocolonography assessed inflammatory activity in the large and small intestine (406 segments) using the MaRIAs index (segmental). MRI data were compared with ileocolonoscopy.Results: ileocolonoscopy showed no signs of inflammatory activity in 71 (71/406, 17.5%) segments. In 168 (168/406, 41.3%) segments endoscopic signs of low or moderate inflammatory activity were detected, in 167 (167/406, 41.2%) segments inflammatory activity with the presence of ulcers were detected. MR-enterocolonography did not detect any activity in 121 (121/406, 29.8%) segments (0 points by MaRIAs index), in 285 (285/406, 70.2%) segments, the inflammation activity was revealed by MaRIAs index from 1 to 5 points. There was a moderate agreement (Cohen’s Kappa: 0.57) between the data of MR-enterocolonography and ileocolonoscopy in detection of affected segments. ROC analysis revealed that with the value of the MaRIAs index (segmental) of 1 point or more with sensitivity of 82.0% and specificity of 92.0% (AUC 0.85), it is possible to consider the presence of inflammatory activity of any severity, and with index value of 2 points or more with sensitivity of 75.0% and specificity of 91.0% (AUC 0.91) can diagnose the severe inflammation with ulcers.Conclusion: the results obtained revealed the value of MaRIAs index and the further study to evaluate the effectiveness of conservative treatment of Crohn’s disease is needed.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":"22 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138952326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Problems of preoperative diagnosis of pelvic lymph node lesions in rectal cancer (review)","authors":"M. Alekseev, E. Khomyakov, E. G. Rybakov","doi":"10.33878/2073-7556-2023-22-4-129-134","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-4-129-134","url":null,"abstract":"Background: metastasis in lateral pelvic lymph nodes (LPLN) occurred in 6–15% of patients with middle or low rectal cancer. Currently there are still no criteria of diagnosis of this. There is no generally accepted management this group of the patients.Aim: to systematize the available literature data about lateral pelvic lymph node dissection in patients with rectal cancer.Materials and Methods: literature search was performed in the PubMed and e-Library databases using the keywords: LLND, lateral lymph node, rectal cancer, lymphodissection. The search date: July 2023.Results: preoperative CRT with total mesorectumectomy supplemented with selective LTLD for suspected metastases seems to be a rational strategy to achieve a favorable oncological treatment outcome.Conclusion: Additional studies are required.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":"50 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138952548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hybrid methods treatments for III and IV grade hemorrhoids","authors":"E. Zagriadskiǐ","doi":"10.33878/2073-7556-2023-22-4-53-61","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-4-53-61","url":null,"abstract":"Aim: to evaluate hybrid techniques in patients with stage III and IV hemorrhoids.Patients and Methods: from January 2017 to December 2021, 154 patients with external and internal hemorrhoids of the 3rd and 4th stages were treated at the Moscow Medical Center “ON CLINIC”, including men — 118 (76.6%) and women — 36 (23.4%), aged of 45.8 ± 10.3 (27–72) years. The history of the disease was 8.8 ± 2.2 (5–15) years. All patients underwait transanal dearterialization with mucopexy. With its inefficiency, a hybrid operation technique was performed.Results: all patients were operated under spinal anesthesia in a one-day hospital. Operation time was 38.05 ± 4.7 (27–55) min. Postoperative pain syndrome on the first day was 34.1 (30–40) mm on the VAS scale, due to the elective use of Ketorolac tromethamine, 30.1 ± 1.2 (30–40) mg. By the 5–6th day, the pain syndrome decreased to 24.2 (20–30) mm and 15.3 (0–30) mm. Hospital stay was 24.5 ± 2.3 (21–38) hours. The mean period of disability was 12.8 ± 3.1 (10–14) days. When comparing the clinical results of treatment with a follow-up period of 29.9 months, there was no progression of the disease manifestation.Conclusion: the use of hybrid techniques in the treatment of complex forms of hemorrhoids allows to minimize trauma of the anal canal and to reduce the rehabilitation period.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":"24 36","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139166133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morpho-functional aspects of various parts of the intestine and risk factors associated with the preventive ileostomy (review)","authors":"A. I. Maksimkin, Z. A. Bagatelia, E. N. Gordienko, E. B. Emelyanova, D. M. Sakaeva","doi":"10.33878/2073-7556-2023-22-4-147-154","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-4-147-154","url":null,"abstract":"Currently, there is no clear answer which option of preventive intestinal stoma should be preferrable after low anterior resection for rectal cancer. The aim of this review was to search predictors of complications of preventive ileostomy. The disorders occur after ileostomy like dehydration, loss of electrolytes, and prerenal acute renal failure, are due to a deficiency of microvilli remaining in the digestion of the small intestine, as well as the inability of the intestine to adapt to new conditions.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":"31 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138950198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}