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Results of rectal resection in metastatic cancer 转移性癌症的直肠切除术结果
Pub Date : 2024-03-21 DOI: 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
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引用次数: 0
ICG-angiography in evaluation the quality of the full-thickness rectal flap's formation at the surgery treatment of complex rectal fistulas ICG 血管造影术在复杂直肠瘘手术治疗中评估全厚直肠瓣形成的质量
Pub Date : 2024-03-21 DOI: 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.
目的:评估在复杂直肠瘘手术治疗中使用 ICG 血管造影术形成全厚直肠皮瓣的可行性。患者和方法:在复杂直肠旁瘘手术治疗中,使用全厚直肠皮瓣进行术中 ICG 血管造影及其视频记录,并在此基础上进行前瞻性队列研究。该研究包括 9 名患者:结果:根据术中 ICG 血管造影确定了 3 种直肠血管结构类型:分别有 3、4 和 5 条直肠动脉远端分支。随后的详细时间测定显示,无论形成的皮瓣宽度如何,动脉期开始的时间都没有显著差异。然而,静脉流出发生了以下变化:当全厚皮瓣宽度为直肠周长的 1/3 时,静脉流出略有延长,表现为最大荧光阶段开始的平均时间增加到 61.5 秒、与完整直肠(58.2 秒)相比,最大荧光阶段开始的平均时间增加到 61.5 秒;当全厚皮瓣宽度为直肠周长的 1/4 时,最大荧光阶段开始的平均时间显著延长(p<0.05),达到 77.6 秒、结论:在使用全厚直肠皮瓣治疗复杂直肠瘘时,ICG-血管造影可以在术中观察到直肠血管,这有助于选择直肠区域的边界以形成全厚皮瓣,还可以评估其血液供应情况。
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引用次数: 0
Juvenile polyposis syndrome (review) 幼年息肉病综合征(回顾)
Pub Date : 2024-03-21 DOI: 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.
幼年息肉病综合征(JPS)是一种罕见的常染色体显性遗传病,其特征是在胃肠道的不同部位(主要是结肠)出现多发性息肉。在 JPS 患者中,除了幼年息肉外,还发现了腺瘤性息肉,这使得与家族性腺瘤性息肉病的鉴别诊断变得非常复杂,在这种情况下,有必要进行根治性手术--直肠结肠切除术。只有在 40-60% 的病例中,才能发现 SMAD4 和 BMPR1A 基因的致病变体,每种变体都有自己的临床表现。JPS 患者的治疗方案包括内窥镜手术和外科手术;然而,俄罗斯的临床指南并未对决策算法和术后随访时间进行评估。这种综合征很少发生,内窥镜诊断和形态学验证困难重重,在确定该病的分子遗传学病因方面也存在局限性,因此有必要开展进一步的研究。
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引用次数: 0
Effectiveness of the total neo-adjuvant therapy in rectal cancer treatment. Results of the randomized trial 新辅助疗法在直肠癌治疗中的有效性。随机试验结果
Pub Date : 2024-03-21 DOI: 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.
患者和方法:将组织学证实为直肠癌的患者随机分为两组:TNT组在新辅助CRT 50-54 Gy加卡培他滨治疗后进行3个XELOX巩固疗程;CTR组为常规新辅助CRT 50-54 Gy加卡培他滨治疗。治疗结束后,使用 mrTRG 量表通过核磁共振成像评估疗效。对于临床反应完全、拒绝手术的患者,采用 "观察与等待 "的方法。其他患者的新辅助治疗效果则通过病理形态学研究使用瑞安量表进行评估。研究的主要终点是完全反应率(临床和病理形态学)。次要研究终点:术中和术后并发症的发生频率和结构、放疗和化疗的 3-4 级毒性发生率、R0-切除率。该研究已在ClinicalTrials.gov(NCT04747951)上注册。结果:2020年10月至2023年10月期间,183名患者参加了随机研究:TNT组91名患者,CRT组92名患者。中位(Q1,Q3)随访期为24(14;28)个月,观察到23%(14/60)的TNT患者和7%(5/71)的THL患者有完全临床应答(P=0.008)。TNT组的pCR率为20%(9/45),CRT组为8%(5/66)(P=0.05)。两组出现3-4级毒性反应的频率、术中和术后并发症的频率和结构以及R0切除的频率在统计学上无显著差异。两组的 3-4 级毒性反应总发生率、术中和术后并发症发生率、R0 切除率无差异。结论:一项随机研究的初步结果表明,新辅助治疗在直肠癌治疗中的有效性和安全性。
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引用次数: 0
Risk factors of sigmoid volvulus in patients with idiopathic megacolon 特发性巨结肠患者出现乙状结肠空洞的风险因素
Pub Date : 2024-03-21 DOI: 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
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引用次数: 0
Mucosal microbiota of the diverticula in inflammatory complications of diverticular disease (a pilot study) 憩室炎症并发症中的憩室黏膜微生物群(试点研究)
Pub Date : 2024-03-21 DOI: 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":" 7","pages":""},"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}
引用次数: 0
Is it safe to leave rectal wound opened after transanal microsurgery? A systematic review and meta-analysis. 经肛门显微手术后开放直肠伤口是否安全?系统回顾和荟萃分析。
Pub Date : 2024-03-21 DOI: 10.33878/2073-7556-2024-23-1-181-187
R. K. Sinitsyn, M. Alekseev, S. Chernyshov, E. G. Rybakov
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引用次数: 0
Colorectal cancer associated with parathyroid hormone-related protein (review) 与甲状旁腺激素相关蛋白有关的结直肠癌(综述)
Pub Date : 2024-03-21 DOI: 10.33878/2073-7556-2024-23-1-162-171
A. Kurzanov, V. M. Durleshter, M. I. Bykov
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引用次数: 0
Diagnostics and treatment of complicated perianal abscess in patients with hematologic malignancies 血液系统恶性肿瘤患者复杂性肛周脓肿的诊断与治疗
Pub Date : 2024-03-21 DOI: 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":"121 3","pages":""},"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}
引用次数: 0
Prognoses of injury scale in surgical treatment of post-traumatic anal incontinence 外伤后肛门失禁手术治疗的损伤量表预后
Pub Date : 2024-03-21 DOI: 10.33878/2073-7556-2024-23-1-71-81
D. Markaryan, A. Lukianov, D. Kiselev, M. Agapov
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引用次数: 0
期刊
Koloproktologia
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