Pub Date : 2024-03-21DOI: 10.33878/2073-7556-2024-23-1-91-99
A. Khitaryan, S. A. Adizov, A. Alibekov, V. N. Kislyakov, A. Orekhov, V. A. Khitaryan, K. S. Oplimakh, A. Golovina
AIM: evaluation the feasibility of usage ICG-angiography for the full-thickness rectal flap's formation at the surgery treatment of complex rectal fistulas.PATIENTS AND METHODS: a prospective cohort study based on the study of intraoperative ICG-angiography and its video recordings in the surgery treatment of complex pararectal fistulas with bringing down a full-thickness rectal flap was performed. The study included 9 patients: 6(66.7%) - men and 3(33.3%) - women.RESULTS: based on intraoperative ICG-angiography 3 types rectum's angioarchitectonics were identified: with 3, 4 and 5 distal branches of the rectal arteries, respectively. Subsequent detailed chronometry were showed that the time of onset of the arterial phase did not differ significantly, regardless of the formed flap's width. However, the following changes in the venous outflow were identified: at full-thickness flap's width of 1/3 of the rectal circumference, a slight lengthening of the venous outflow was observed, expressed in an increase of the average time for onset of the maximum fluorescence phase to 61.5 sec., compared with the intact rectum (58.2 sec.); at full-thickness flap's width of 1/4 of the rectal circumference - significant (p<0.05) extension of the average time for onset of the phase of maximum fluorescence to 77.6 sec., that is, in 1.26 times compared to patients with flap's width of 1/3 of the rectal circumference.CONCLUSION: at the treatment of complex rectal fistulas with bringing down a full-thickness rectal flap, ICG-angiography makes it possible to visualize the vessels of the rectum at intraoperative condition, which contributes to the selection of the boundaries of the rectal area for the formation of a full-thickness flap, and also allows to assess of its blood supply.
{"title":"ICG-angiography in evaluation the quality of the full-thickness rectal flap's formation at the surgery treatment of complex rectal fistulas","authors":"A. Khitaryan, S. A. Adizov, A. Alibekov, V. N. Kislyakov, A. Orekhov, V. A. Khitaryan, K. S. Oplimakh, A. Golovina","doi":"10.33878/2073-7556-2024-23-1-91-99","DOIUrl":"https://doi.org/10.33878/2073-7556-2024-23-1-91-99","url":null,"abstract":"AIM: evaluation the feasibility of usage ICG-angiography for the full-thickness rectal flap's formation at the surgery treatment of complex rectal fistulas.PATIENTS AND METHODS: a prospective cohort study based on the study of intraoperative ICG-angiography and its video recordings in the surgery treatment of complex pararectal fistulas with bringing down a full-thickness rectal flap was performed. The study included 9 patients: 6(66.7%) - men and 3(33.3%) - women.RESULTS: based on intraoperative ICG-angiography 3 types rectum's angioarchitectonics were identified: with 3, 4 and 5 distal branches of the rectal arteries, respectively. Subsequent detailed chronometry were showed that the time of onset of the arterial phase did not differ significantly, regardless of the formed flap's width. However, the following changes in the venous outflow were identified: at full-thickness flap's width of 1/3 of the rectal circumference, a slight lengthening of the venous outflow was observed, expressed in an increase of the average time for onset of the maximum fluorescence phase to 61.5 sec., compared with the intact rectum (58.2 sec.); at full-thickness flap's width of 1/4 of the rectal circumference - significant (p<0.05) extension of the average time for onset of the phase of maximum fluorescence to 77.6 sec., that is, in 1.26 times compared to patients with flap's width of 1/3 of the rectal circumference.CONCLUSION: at the treatment of complex rectal fistulas with bringing down a full-thickness rectal flap, ICG-angiography makes it possible to visualize the vessels of the rectum at intraoperative condition, which contributes to the selection of the boundaries of the rectal area for the formation of a full-thickness flap, and also allows to assess of its blood supply.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140222023","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}
Pub Date : 2024-03-21DOI: 10.33878/2073-7556-2024-23-1-142-151
T. A. Vlasko, A. Likutov, V. Veselov, A. A. Ponomarenko, A. S. Tsukanov
Juvenile polyposis syndrome (JPS), a rare disease with an autosomal dominant mode of inheritance, which is characterized with the presence of multiple polyps in various parts of the gastrointestinal tract, mainly in the colon. The detection of adenomatous polyps in patients with JPS, in addition to juvenile ones, significantly complicates the differential diagnosis with familial adenomatous polyposis, in which it is necessary to perform a radical surgery — proctocolectomy. Only in 40-60% of cases, pathogenic variants of the SMAD4 and BMPR1A genes can be identified, each of which is characterized with its own clinical manifestations. Treatment options for patients with JPS include endoscopic and surgical; however, the decision-making algorithm, as well as the timing of postoperative follow-up, are not evaluated in Russian clinical guidelines. The rare occurrence of this syndrome, difficulties in endoscopic diagnosis and morphological verification, as well as limitations in determining the molecular genetics cause of the disease demonstrate the need for further research.
{"title":"Juvenile polyposis syndrome (review)","authors":"T. A. Vlasko, A. Likutov, V. Veselov, A. A. Ponomarenko, A. S. Tsukanov","doi":"10.33878/2073-7556-2024-23-1-142-151","DOIUrl":"https://doi.org/10.33878/2073-7556-2024-23-1-142-151","url":null,"abstract":"Juvenile polyposis syndrome (JPS), a rare disease with an autosomal dominant mode of inheritance, which is characterized with the presence of multiple polyps in various parts of the gastrointestinal tract, mainly in the colon. The detection of adenomatous polyps in patients with JPS, in addition to juvenile ones, significantly complicates the differential diagnosis with familial adenomatous polyposis, in which it is necessary to perform a radical surgery — proctocolectomy. Only in 40-60% of cases, pathogenic variants of the SMAD4 and BMPR1A genes can be identified, each of which is characterized with its own clinical manifestations. Treatment options for patients with JPS include endoscopic and surgical; however, the decision-making algorithm, as well as the timing of postoperative follow-up, are not evaluated in Russian clinical guidelines. The rare occurrence of this syndrome, difficulties in endoscopic diagnosis and morphological verification, as well as limitations in determining the molecular genetics cause of the disease demonstrate the need for further research.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140222435","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}
Pub Date : 2024-03-21DOI: 10.33878/2073-7556-2024-23-1-52-58
O. I. Kit, Y. Gevorkyan, N. Soldatkina, E. Kolesnikov, M. S. Gusareva, O. Bondarenko, A. E. Anisimov, L. Vladimirova
{"title":"Results of rectal resection in metastatic cancer","authors":"O. I. Kit, Y. Gevorkyan, N. Soldatkina, E. Kolesnikov, M. S. Gusareva, O. Bondarenko, A. E. Anisimov, L. Vladimirova","doi":"10.33878/2073-7556-2024-23-1-52-58","DOIUrl":"https://doi.org/10.33878/2073-7556-2024-23-1-52-58","url":null,"abstract":"","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140221936","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}
Pub Date : 2024-03-21DOI: 10.33878/2073-7556-2024-23-1-10-20
S. Sychev, E. G. Rybakov, M. Alekseev, S. Chernyshov, A. A. Ponomarenko
To ASSESS effectiveness of total neoadjuvant therapy (TNT) for patients with rectal carcinoma.Patients and methods: patients with histologically proven rectal carcinoma were randomly assigned in two groups: in the TNT group after the neoadjuvant CRT 50-54 Gy with capecitabine 3 consolidation courses of XELOX were done, in the CTR group - conventional neoadjuvant CRT 50-54 Gy with capecitabine. At the end of the treatment, effect was assessed by MRI using the mrTRG scale. For patients with a full clinical response, who have refused surgery, «watch&wait» approach was used. For other patients effect of neoadjuvant therapy was evaluated by pathomorphological study using the Ryan scale. The primary endpoint of study was the complete response rate (clinical and pathomorphological). Secondary endpoints of study: frequency and structure of intraoperative and postoperative complications, the rate of grade 3–4 toxicity of radiotherapy and chemotherapy, R0-resection rates. The study was registered on the ClinicalTrials.gov (NCT04747951)RESULTS: between October 2020 and October 2023, 183 patients were enrolled in the randomized study: 91 patients in the TNT group and 92 patients in the CRT group. At median (Q1, Q3) follow-up period 24 (14; 28) months, complete clinical response observed in 23% (14/60) of TNT patients and in 7% (5/71) of THL patients (p=0.008). The pCR rate was 20% (9/45) in the TNT group and 8% (5/66) in the CRT group (p=0.05). The frequency of development of toxic reactions of degree 3-4, the frequency and structure of intra- and postoperative complications, as well as the frequency of R0 resection of the group did not differ statistically significantly. The total rate of Grade 3–4 toxicity, rate of intra- and postoperative complications, R0-resections rate did not differ between two groups.CONCLUSION: preliminary results of a randomized study demonstrated the effectiveness and safety of total neo-adjuvant therapy in rectal cancer treatment.
{"title":"Effectiveness of the total neo-adjuvant therapy in rectal cancer treatment. Results of the randomized trial","authors":"S. Sychev, E. G. Rybakov, M. Alekseev, S. Chernyshov, A. A. Ponomarenko","doi":"10.33878/2073-7556-2024-23-1-10-20","DOIUrl":"https://doi.org/10.33878/2073-7556-2024-23-1-10-20","url":null,"abstract":"To ASSESS effectiveness of total neoadjuvant therapy (TNT) for patients with rectal carcinoma.Patients and methods: patients with histologically proven rectal carcinoma were randomly assigned in two groups: in the TNT group after the neoadjuvant CRT 50-54 Gy with capecitabine 3 consolidation courses of XELOX were done, in the CTR group - conventional neoadjuvant CRT 50-54 Gy with capecitabine. At the end of the treatment, effect was assessed by MRI using the mrTRG scale. For patients with a full clinical response, who have refused surgery, «watch&wait» approach was used. For other patients effect of neoadjuvant therapy was evaluated by pathomorphological study using the Ryan scale. The primary endpoint of study was the complete response rate (clinical and pathomorphological). Secondary endpoints of study: frequency and structure of intraoperative and postoperative complications, the rate of grade 3–4 toxicity of radiotherapy and chemotherapy, R0-resection rates. The study was registered on the ClinicalTrials.gov (NCT04747951)RESULTS: between October 2020 and October 2023, 183 patients were enrolled in the randomized study: 91 patients in the TNT group and 92 patients in the CRT group. At median (Q1, Q3) follow-up period 24 (14; 28) months, complete clinical response observed in 23% (14/60) of TNT patients and in 7% (5/71) of THL patients (p=0.008). The pCR rate was 20% (9/45) in the TNT group and 8% (5/66) in the CRT group (p=0.05). The frequency of development of toxic reactions of degree 3-4, the frequency and structure of intra- and postoperative complications, as well as the frequency of R0 resection of the group did not differ statistically significantly. The total rate of Grade 3–4 toxicity, rate of intra- and postoperative complications, R0-resections rate did not differ between two groups.CONCLUSION: preliminary results of a randomized study demonstrated the effectiveness and safety of total neo-adjuvant therapy in rectal cancer treatment.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140221884","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}
Pub Date : 2024-03-21DOI: 10.33878/2073-7556-2024-23-1-32-41
D. Aleshin, S. I. Achkasov, D. Shakhmatov, O. Fomenko, A. A. Ponomarenko, M. A. Ignatenko, E. Surovegin, O. Sushkov
{"title":"Risk factors of sigmoid volvulus in patients with idiopathic megacolon","authors":"D. Aleshin, S. I. Achkasov, D. Shakhmatov, O. Fomenko, A. A. Ponomarenko, M. A. Ignatenko, E. Surovegin, O. Sushkov","doi":"10.33878/2073-7556-2024-23-1-32-41","DOIUrl":"https://doi.org/10.33878/2073-7556-2024-23-1-32-41","url":null,"abstract":"","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140221328","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}
Pub Date : 2024-03-21DOI: 10.33878/2073-7556-2024-23-1-108-116
R. R. Shakirov, Yu. S. Pankratova, A. M. Senina, E. Boulygina, O. S. Karaseva, T. Grigoryeva, D. Yarullina, O. Karpukhin
{"title":"Mucosal microbiota of the diverticula in inflammatory complications of diverticular disease (a pilot study)","authors":"R. R. Shakirov, Yu. S. Pankratova, A. M. Senina, E. Boulygina, O. S. Karaseva, T. Grigoryeva, D. Yarullina, O. Karpukhin","doi":"10.33878/2073-7556-2024-23-1-108-116","DOIUrl":"https://doi.org/10.33878/2073-7556-2024-23-1-108-116","url":null,"abstract":"","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140221906","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}
Pub Date : 2024-03-21DOI: 10.33878/2073-7556-2024-23-1-181-187
R. K. Sinitsyn, M. Alekseev, S. Chernyshov, E. G. Rybakov
{"title":"Is it safe to leave rectal wound opened after transanal microsurgery? A systematic review and meta-analysis.","authors":"R. K. Sinitsyn, M. Alekseev, S. Chernyshov, E. G. Rybakov","doi":"10.33878/2073-7556-2024-23-1-181-187","DOIUrl":"https://doi.org/10.33878/2073-7556-2024-23-1-181-187","url":null,"abstract":"","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140221889","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}
Pub Date : 2024-03-21DOI: 10.33878/2073-7556-2024-23-1-162-171
A. Kurzanov, V. M. Durleshter, M. I. Bykov
{"title":"Colorectal cancer associated with parathyroid hormone-related protein (review)","authors":"A. Kurzanov, V. M. Durleshter, M. I. Bykov","doi":"10.33878/2073-7556-2024-23-1-162-171","DOIUrl":"https://doi.org/10.33878/2073-7556-2024-23-1-162-171","url":null,"abstract":"","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140221753","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}
Pub Date : 2024-03-21DOI: 10.33878/2073-7556-2024-23-1-117-128
S. V. Shtyrkova, O. A. Soboleva, K. R. Sabirov, V. A. Novikov, K. I. Ntanishyan, E. N. Parovichnikova
{"title":"Diagnostics and treatment of complicated perianal abscess in patients with hematologic malignancies","authors":"S. V. Shtyrkova, O. A. Soboleva, K. R. Sabirov, V. A. Novikov, K. I. Ntanishyan, E. N. Parovichnikova","doi":"10.33878/2073-7556-2024-23-1-117-128","DOIUrl":"https://doi.org/10.33878/2073-7556-2024-23-1-117-128","url":null,"abstract":"","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140223157","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}
Pub Date : 2024-03-21DOI: 10.33878/2073-7556-2024-23-1-71-81
D. Markaryan, A. Lukianov, D. Kiselev, M. Agapov
{"title":"Prognoses of injury scale in surgical treatment of post-traumatic anal incontinence","authors":"D. Markaryan, A. Lukianov, D. Kiselev, M. Agapov","doi":"10.33878/2073-7556-2024-23-1-71-81","DOIUrl":"https://doi.org/10.33878/2073-7556-2024-23-1-71-81","url":null,"abstract":"","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140221962","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}
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