Koloproktologia最新文献

{"title":"Early outcomes of chronic anal fissure treatment using the lateral internal sphincterotomy method without excision (randomized trial NCT05117697)","authors":"N. A. Goloktionov, A. Titov, A. Ponomarenko, K. I. Sagidova, E. Lebedeva, A. A. Mudrov, E. Zharkov","doi":"10.33878/2073-7556-2023-22-3-50-61","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-3-50-61","url":null,"abstract":"PURPOSE OF THE STUDY: improvement of the treatment of chronic anal fissure results.PATIENTS AND METHODS: the study included 70 patients randomized by random number generation into 2 groups: 30 patients underwent lateral internal sphincterotomy (main group, LIS), and 40 patients underwent LIS in combination with the excision of the fissure (EF) (control group, LIS + EF).RESULTS: the pain intensity both after stool and during the daytime in the main group (LIS) has been significantly lower than in the control group (LIS + EF) (p < 0.05). The median duration of the patients’ temporary disability in the LIS group was 6 (4; 9) days, in the LIS + EF group — 17 (9; 23.5) days (p = 0.04). On day 15, the defect has epithelialized in 12/30 (40%) patients of the main group (LIS) and none (0/40) in the control group (LIS + EF) (p = 0.00001), on day 30 — in 22/30 (73.3%) and 2/40 (5%) (p = 0.00001), on day 45 — in 26/30 (87%) and 20/40 (50%) (p = 0.002), and on day 60 — in 28/30 (93.3%) and 38/40 (95%) (p = 1.0), respectively. On the day 30 after surgery, 3/30 (10%) patients of the main group and 15/40 (37.5%) of the control group had complaints regarding passing gas (p = 0.01), on day 60 — anal sphincter insufficiency (ASI) persisted in 1/30 (3%) patients in the LIS group and in 3/40 (7.5%) patients in the LIS + EF group (p = 0.63). Excision of the fissure in 5.4 (1.4–20.9) times increases the chance of developing ASI on day 30 of the postoperative period (p = 0.015) and 52 (10.2; 268.3) times increases the chance of non-healing of the defect during this period (p = 0.000002) and 6.5 (1.9; 22) times on the day 45 (p = 0.003), in comparison with the LIS only.CONCLUSION: refusal to excise the anal fissure during its surgical treatment and perform the lateral internal sphincterotomy only can reduce the intensity of postoperative pain syndrome, the rate of postoperative complications and reduce the time of epithelialization of the anoderm defect.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81706146","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":"Endoscopic injections of autoplasma rich in platelets in the treatment of postradiation ulcers of the rectum","authors":"A. V. Leontev, Elena A. Grishina, M. Danilov, Irina V. Nadina, K. Shishin","doi":"10.33878/2073-7556-2023-22-3-85-93","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-3-85-93","url":null,"abstract":"AIM: to develop a technique and evaluate the effectiveness of endoscopic injections of autoplasma rich in platelets (PRP) in patients with post-radiation rectal ulcers.PATIENTS AND METHODS: 41 patients with post-radiation rectal ulcer underwent endoscopic injections of APBT to epithelialize the ulcer.RESULTS: The average number of injections for epithelialization of a post-radiation ulcer is 5. 31(75.6%) patients during the manipulation of the sermon pain syndrome, the severity of full strength on the scale of the analog-analogue scale. In 39 (95.1%) patients, complete healing of the post-radiation ulcer of the rectum was diagnosed after endoscopic injections of PRP.CONCLUSION: PRP endoscopic injections are a technically feasible, safe and effective method in the treatment of patients with post-radiation rectal ulcers.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83520219","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":"Open or closed sphincterotomy for treatment of the chronic anal fissure? (systematic review and meta-analysis)","authors":"Nikolay A. Goloktionov, Aleksey A. Ponomarenko, K. I. Sagidova, Ekaterina Yu. Lebedeva, A. A. Mudrov, Evgeny E. Zharkov","doi":"10.33878/2073-7556-2023-22-3-149-157","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-3-149-157","url":null,"abstract":"INTRODUCTION: up to the present time, both open and closed lateral internal sphincterotomy (LIS) are considered by surgeons as fully comparable methods for eliminating the spasm of the internal sphincter in patients with chronic anal fissure. However, each method has a number of advantages and disadvantages. AIM: determination of an effective and safe method of lateral subcutaneous sphincterotomy.MATERIALS AND METHODS: a systematic overview and meta-analysis of studies, which compare the results of treatment after an open and closed lateral sphincterotomy was performed. The following has been evaluated: the incidence of fissure epithelialization, the postoperative morbidity, the recurrence rate, the incidence of anal incontinence (AI). Statistical processing has been carried out in the Review Manager 5.3 program.RESULTS: the meta-analysis included 9 studies with the results of treatment of 452 patients after an open lateral sphincterotomy and 443 after a closed one. The groups were comparable in frequency of epithelialization of fissures (OR = 0.87; CI = 0.30; 2.53; p = 0.8), in terms of the number of postoperative complications (OR = 0.52; CI = 0.15; 1.76; p = 0.29), as well as the number of relapses of the disease (OR = 0.5; CI = 0.19; 1.31; p = 0.16). At the same time, the implementation of an open lateral sphincterotomy leads to the development of AI 2.05 times more often than the closed method (OR = 2.05; CI = 1.01; 4.16; p = 0.05).CONCLUSION: during the treatment of the chronic anal fissure, in order to eliminate the spasm of the internal sphincter, it is advisable to use a closed method, in which the chance of AI is 2.05 times lower.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89732867","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":"Crohn’s disease penetrating form. Difficulties of diagnostics and preoperative planning (clinical case)","authors":"M. Y. Belikovа, T. L. Gorshenin, I. K. Borovik, Yu. A. Sizov","doi":"10.33878/2073-7556-2023-22-3-121-127","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-3-121-127","url":null,"abstract":"AIM: to demonstrate the difficulties of differential diagnosis of the penetrating variant of Crohn’s disease and malignant neoplasm of the intestine.PATIENTS AND METHODS: a clinical case of a patient of an older age group with the onset of a penetrating variant of Crohn’s disease is presented.RESULTS: according to the results of an urgent check-up on the day of admission, the patient had an abdominal mass in the right iliac region, involving the intestinal wall, anterior abdominal wall, complicated by acute intestinal obstruction. Preliminary diagnosis: colon tumor complicated by inflammation and acute intestinal obstruction. The patient’s condition and two life-threatening complications required an urgent surgical intervention — extended right-sided hemicolectomy. The primary histological examination also did not allow us to exclude the tumor nature, but a second revision of histology with immunohistochemical analysis made it possible to establish the diagnosis of Crohn’s disease.CONCLUSION: Crohn’s disease can debut at any age, including complicated forms. This requires the inclusion of this pathology in the differential diagnosis with malignant neoplasms of the intestine, especially when the changes are located in the right iliac region. This will help to optimize the surgical approach.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":"97 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85897811","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":"Comparative characteristics of scales for assessing the quality of life of stoma patients (review)","authors":"R. I. Babazada, A. A. Vaganov, V. Morozov, A. Korolkov","doi":"10.33878/2073-7556-2023-22-3-134-139","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-3-134-139","url":null,"abstract":"AIM: to compare various scales for assessing the quality of life of stoma patients in order to provide the most complete and objective assessment.MATERIALS AND METHODS: literature sources from the medical databases PubMed, MedLine, Scopus were analyzed. The studied literature sources were published in different countries, which made it possible to identify both global and country-specific criteria for assessing the quality of life of patients.CONCLUSION: the specific SQOLS and Stoma-QOL scales are of the greatest scientific and practical value, and the nonspecific SF-36 scale does not lose its scientific significance. These scales are most often used in various medical and scientific institutions to study the life of ostomy patients. They are simple and easy to use, their reliability and validity have been proven by specially conducted studies.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":"87 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83073908","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":"Validation of the risk questionnaire for colorectal cancer detection","authors":"D. P. Kulovskaya, Y. Shelygin, S. Frolov, S. Achkasov","doi":"10.33878/2073-7556-2023-22-3-76-84","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-3-76-84","url":null,"abstract":"AIM: to develop and validate of the colorectal cancer screening questionnaire.PATIENTS AND METHODS: six hundred ninety seven patients without any significant complaints were prospectively included in study. All patients underwent colonoscopy and specific questionnaire. Regression model was performed to stratificate significance level of definite questions.RESULTS: colorectal cancer (CRC) was diagnosed in 39 (5.6%) patients, benign colon neoplasms — in 283 (40.6%) patients. In the ROC analysis, a cut-off of 23 points divides the group of patients into high and low risk of colorectal neoplasms with a sensitivity of 92.8% and a specificity of 39.2%. The area under the curve was 0.724, which corresponds to the good predictive value.CONCLUSION: the developed questionnaire show good predictive power for high CRC risk patients identification, and can be included in the screening program model.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80628122","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":"Validation and adaptation of the Russian version colostomy impact score (CIS)","authors":"E. Khomyakov, D. Y. Pikunov, Z. Mamedli, A. Karachun, N. V. Kostenko, I. V. Zhilin, I. Ignatov, A. Medvednikov, A. I. Moskalev, T. S. Khakamov, V. B. Skopintsev, S. N. Lukmonov, D. Samsonov, А. G. Razuvailova, Y. B. Lee, S. Radostev, R. T. Ayupov, N. V. Malgina, S. Achkasov, E. Rybakov","doi":"10.33878/2073-7556-2023-22-3-112-120","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-3-112-120","url":null,"abstract":"BACKGROUND: The number of people with intestinal stomas in Russia reaches 140 thousand people according to the registry of stoma patients. For any outcomes stoma on the anterior abdominal wall has an extremely negative effect on the body image and quality of life of this patient.AIM: Validation and cultural adaptation of the CIS questionnaire in the Russian Federation.MATERIALS AND METHODS: The official translation of the CIS questionnaire was performed according to current WHO and EORTC guidelines. The study involved 209 patients from 9 centers (3 national and 6 regional) from different districts of Russia.RESULTS: The stoma impact on quality-of-life questionnaire showed an inverse negative relationship with the EORTC QLQ-C30 global quality of life scale, physical, role, emotional and social functioning (all p<0,05).CONCLUSION: The CIS Questionnaire reliably identifies a group of patients with a significant impairment in the quality of life and can be used in Russia.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90639161","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":"Surgical treatment of familial adenomatous polyposis in children: cross-sectional study","authors":"L. R. Khabibullina, A. Razumovsky, O. Sherbakova","doi":"10.33878/2073-7556-2023-22-3-104-109","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-3-104-109","url":null,"abstract":"Familial adenomatous polyposis (FAP) is an autosomal dominant disease caused by the APC gene mutation, characterized by colon adenomas and colorectal cancer, including in children. The issue of timing and indications for surgical treatment of FAP in childhood remains debatable.AIM: to identify predictors of surgery for FAP in pediatric patients.PATIENTS AND METHODS: a retrospective case-control study was conducted. The results of treatment of 50 children with FAP who were in the surgical department of the Russian Children's Clinical Hospital from January 2000 to April 2023 were analyzed. Two groups were formed: patients who underwent surgery of FAP under the age of 18 (case), and patients who did not undergo surgery at this age (control). We analyzed potential predictors: the age of manifestation, the clinical, the characteristics of adenomas, the anemia and family history, polyposis of the upper gastrointestinal tract.RESULTS: in the surgical group, the proportion of patients with more than 100 adenomas was higher (23 (88%) versus 11 (45%) (p=0.002)). It was revealed that the number of adenomas was more than 100 at the time of the first colonoscopy (OR 12 (95% CI (3–80), p=0.02) and the presence of colon bleeding (OR 5.8 (95% CI 1–35, p=0 .03) are independent predictors of colproctectomy in children.CONCLUSION: the number of adenomas over 100 and colon bleeding are independent predictors of colproctectomy in childhood.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":"172 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77938408","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 efficacy of neoadjuvant chemoradiotherapy in signet ring cell carcinoma of the rectum: a retrospective propensity-score matched study","authors":"S. Gordeev, Ya. V. Belenkaya, Z. N. Magarramova, I. Komarov, A. Malikhov, Z. Mamedli, I. Stilidi","doi":"10.33878/2073-7556-2023-22-3-62-69","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-3-62-69","url":null,"abstract":"INTRODUCTION: there is a lack of information chemoradiotherapy (CRT) efficacy in signet ring cell carcinoma of the rectum (SRCCR). The aim of our research was to investigate the efficacy of preoperative CRT in patients with SRCCR.PATIENTS AND METHODS: we conducted a retrospective analysis of medical records from the archive of Research Institute FSBI “N.N. Blokhin Cancer Research Center” of the Ministry of Health of Russia and multicenter registry of the Russian Society of Specialists in Colorectal Cancer (RSSCC) from 2000 to 2020 and included in the study group patients with histologically confirmed primary SRCCR who received preoperative CRT. A control group with rectal adenocarcinoma was created using propensity-score matching from the institutional database 1:1 taking into account sex, age, tumor size, the cT and cN clinical stage. We estimated the rate of Dworak tumor regression grade 3-4, RECIST, 5-year overall survival (OS) and disease-free survival (DFS) rates.RESULTS: the study and control group included 22 patients each. The study group included 11 patients (50%) with cT3 and cT4 clinical stage. 10 (45,5%) patients had cT3 clinical stage and 12 (54,5%) patients had cT4 clinical stage in the control group (p = 0,763). The number of patients with cN1-2 clinical stage was 17 (77,3%) and 16 (72,7%) in the study and control group, respectively (p = 0,728). The rate of Dworak tumor regression grade 3–4 was 40,9% in the group of patients with SRCCR and 45,5% in the group of patients with rectal adenocarcinoma (p = 0,761).When assessed by RECIST scale, 9 (40,9%), 12 (54,5%) and 1 (4,5%) patients with SRCCR had partial tumor response, stabilization and progression, respectively. Partial response was observed in 18 (81,8%) patients and stabilization — in 4 (18,2%) patients with rectal adenocarcinoma (p = 0,018). Median followup was 58,8 months. The 5-year OS was 34% in the SRCCR group and 71,3% in the group with rectal adenocarcinoma (p = 0,024), and the 5-year PFS was 30,2% with SRCCR and 52,2% with adenocarcinoma (p = 0,115).CONCLUSIONS: CRT leads to comparable grade 3–4 tumor regression in SRCCR and rectal adenocarcinoma, but the objective response rate is lower. This histological subtype has significantly lower OS values.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84377450","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":"Comparison of transanal endomicrosurgery and total mesorectumectomy in treatment of early rectal cancer (a systematic literature review and meta-analysis)","authors":"S. Chernyshov, M. Nagudov, Y. Shelygin, O. Maynovskaya, Philip I. Kirgizov, Polina I. Chupina, E. G. Rybakov","doi":"10.33878/2073-7556-2023-22-3-176-183","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-3-176-183","url":null,"abstract":"Transanal endomicrosurgery (TEM) presently is the only method for local excision of early rectal cancer with sufficient visualization, possibility for full-wall excision to achieve adequately deep margin of resection for disease staging. Despite the obvious advantage in immediate outcomes of transanal endomicrosurgery over mesorectumectomy, nowadays only in a small number of studies the oncological outcomes were compared. In this regard were performed a systematic review of literature and meta-analysis.AIM OF THE STUDY: to compare the immediate (frequency of complications, duration of operation and intraoperative blood loss) and long-term (frequency of distant metastases and local recurrences) results of TEM and mesorectumectomy in early rectal cancer.MATERIALS AND METHODS: literature search was performed according to PRISMA guidelines. Statistical processing of data was performed with use of Review Manager 5.3. Program.RESULTS: in 4 studies (1 randomized, 2 retrospective, 1 prospective), that were included in meta-analysis the results of treatment of 422 patients were described (240-TEM, 182-mesorectumectomy). The odds-ratio of incidence of postoperative complications after mesorectumectomy was higher for almost 5 times than after TEM (OR 0,21; 95% CI: 0,06 0,74; p = 0,02), as well as the frequency of reoperations in case for complications (OR 0,16; 95% CI: 0,06 0,59; p = 0,02). As well as the overall recurrence rate in TEM group (OR 2,37; 95% CI:1,04 5,39 p = 0,04), the rate of local recurrence (OR 4,61; 95% CI: 1,08 19,6; p = 0,04) was statistically higher than in total mesorectumectomy. At the same time there were no statistically significant difference in incidence of distant metastases (OR 01,0; 95% CI: 0,35 2,84; p = 1,0).CONCLUSION: transanal endomicrosurgery is the method of choice and is safer than mesorectumectomy. However, oncological outcomes depend on many factors which presence must be taken into account when planning for surgical treatment of early rectal cancer.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":"116 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87758177","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}