Pub Date : 2023-06-21DOI: 10.33878/2073-7556-2023-22-2-103-111
A. Seidinovich, S. Gordeev, A. Markovich, I. Komarov, D. V. Alexancev, Z. Mamedli
AIM: to evaluate the effectiveness of first-line chemotherapy in patients with colorectal neuroendocrine cancer (NEC).PATIENTS AND METHODS: a retrospective study included patients with metastatic colorectal NEC (2000-2020). The main analyzed parameter was the response rate to treatment according to the RECIST criteria, depending on the regimen used in the first line. The overall survival was additional parameter.RESULTS: the study included 27 patients (13 with initial stage IV disease and 14 with progression after primary radical treatment). Ten patients in the 1st line underwent chemotherapy according to the EP scheme, 4 — XELOX, 2 — FOLFIRI, 2 — Irinotecan and Cisplatin, 1 — Samarium, 1 — Nivolumab, 1 — 5-FU-LV. Most often, the treatment effect (partial response or stabilization) was observed against the background of chemotherapy according to the EP scheme — in 60% of patients. The median OS was 7 months.CONCLUSION: the use of chemotherapy according to the EP regimen is the preferred options for the treatment of metastatic colorectal NEC. The median OS in this group of patients remains extremely low, and new clinical trials are needed.
{"title":"Chemotherapy efficacy in metastatic neuroendocrine colorectal cancer","authors":"A. Seidinovich, S. Gordeev, A. Markovich, I. Komarov, D. V. Alexancev, Z. Mamedli","doi":"10.33878/2073-7556-2023-22-2-103-111","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-2-103-111","url":null,"abstract":"AIM: to evaluate the effectiveness of first-line chemotherapy in patients with colorectal neuroendocrine cancer (NEC).PATIENTS AND METHODS: a retrospective study included patients with metastatic colorectal NEC (2000-2020). The main analyzed parameter was the response rate to treatment according to the RECIST criteria, depending on the regimen used in the first line. The overall survival was additional parameter.RESULTS: the study included 27 patients (13 with initial stage IV disease and 14 with progression after primary radical treatment). Ten patients in the 1st line underwent chemotherapy according to the EP scheme, 4 — XELOX, 2 — FOLFIRI, 2 — Irinotecan and Cisplatin, 1 — Samarium, 1 — Nivolumab, 1 — 5-FU-LV. Most often, the treatment effect (partial response or stabilization) was observed against the background of chemotherapy according to the EP scheme — in 60% of patients. The median OS was 7 months.CONCLUSION: the use of chemotherapy according to the EP regimen is the preferred options for the treatment of metastatic colorectal NEC. The median OS in this group of patients remains extremely low, and new clinical trials are needed.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78162776","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 : 2023-06-21DOI: 10.33878/2073-7556-2023-22-2-57-63
A. V. Galyaev, E. Surovegin, A. Likutov, O. Sushkov, Yu. E. Vaganov, A. S. Voskanyan, E. Merkulova
AIM: to evaluate the impact of dietary compliance in bowel cleansing for colonoscopy on the quality of the procedure.PATIENTS AND METHODS: one thousand patients who scheduled for diagnostic colonoscopy were included in the prospective observation study. The quality of bowel preparation was assessed using the Boston scale. Neoplasms were detected and endoscopically evaluated. The optical verification of tumors was used to calculate the indicators of identified adenomas and polyps (ADR and PDR).RESULTS: the quality of bowel cleansing by the Boston Scale was 6 (6; 8) points. One hundred eight (19.8%) patients did not follow the recommended diet. Poor preparation, which did not allow a total colonoscopy was found in 91 (9,1%) cases. The ADR was 37.4%, PDR — 43.4%. Logistic regression analysis showed that the noncompliance for diet recommendation was the only one significantly negative factor associated whit inadequate bowel cleansing.CONCLUSION: the leading factor worsening the quality of bowel cleansing was non-compliance with the prescribed diet before the colonoscopy.
{"title":"The role of diet in bowel cleansing for colonoscopy (results of prospective observation study). Prospective observations study","authors":"A. V. Galyaev, E. Surovegin, A. Likutov, O. Sushkov, Yu. E. Vaganov, A. S. Voskanyan, E. Merkulova","doi":"10.33878/2073-7556-2023-22-2-57-63","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-2-57-63","url":null,"abstract":"AIM: to evaluate the impact of dietary compliance in bowel cleansing for colonoscopy on the quality of the procedure.PATIENTS AND METHODS: one thousand patients who scheduled for diagnostic colonoscopy were included in the prospective observation study. The quality of bowel preparation was assessed using the Boston scale. Neoplasms were detected and endoscopically evaluated. The optical verification of tumors was used to calculate the indicators of identified adenomas and polyps (ADR and PDR).RESULTS: the quality of bowel cleansing by the Boston Scale was 6 (6; 8) points. One hundred eight (19.8%) patients did not follow the recommended diet. Poor preparation, which did not allow a total colonoscopy was found in 91 (9,1%) cases. The ADR was 37.4%, PDR — 43.4%. Logistic regression analysis showed that the noncompliance for diet recommendation was the only one significantly negative factor associated whit inadequate bowel cleansing.CONCLUSION: the leading factor worsening the quality of bowel cleansing was non-compliance with the prescribed diet before the colonoscopy.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86402339","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 : 2023-06-21DOI: 10.33878/2073-7556-2023-22-2-172-183
Y. Shelygin, S. Achkasov, I. Reshetov, I. V. Mayev, O. Drapkina, E. Belousova, A. Vardanyan, B. Nanaeva, D. Abdulganieva, L. Adamyan, L. Namazova-Baranova, A. Razumovsky, A. Revishvili, I. Khatkov, A. Shabunin, M. Livzan, A. Sazhin, V. M. Timerbulatov, O. Khlynova, S. Yatsyk, R. Abdulkhakov, O. P. Alekseeva, S. Alekseenko, I. Bakulin, O. Barysheva, D. A. Blagovestnov, K. Bolikhov, V. Veselov, Y. Vinogradov, O. Golovenko, I. Gubonina, A. Gulyaev, A. Dolgushina, E. Dyakonova, T. Zhigalova, O. Karpukhin, O. Knyazev, N. V. Kostenko, I. D. Loranskaya, A. Moskalev, A. Odintsova, V. V. Omelyanovsky, M. Osipenko, V. Pavlenko, E. Poluektova, D. Popov, G. Rodoman, A. Segal, S. Sitkin, M. I. Skalinskaya, A. Surkov, L. V. Tarasova, Y. B. Uspenskaya, S. Frolov, E. Chashkova, S. Shapovalyants, O. Shifrin, O. Shcherbakova, O. Shchukina, T. Shkurko, I. Nazarov, A. Mingazov
AIM: to establish the consensus on controversial issues of the surgery for Сrohn’s disease by Delphi method.METHODS: a cross-sectional study was conducted by the Delphi method. 62 experts voted intramural and anonymous (31.03.23). 5 statements from the current edition of clinical guidelines were selected for correction by working group and further voting [2]. Based on the practical experience of the working group and literature data, 3 new statements were created also. Statements that do not reach the required level of agreement (80% or more) will be subjected to Round 2 of the Delphi method.RESULTS: all experts took part in the anonymous voting. The panel of experts is represented by 8 different areas of practical medicine and the median of the professional experience of the respondents was 30 (12–49) years. Of the 8 statements submitted for voting, consensus (80% or more) was reached on 6 out of 8. 2 statements have been revised by working group for the distance 2nd round of the Delphi study. Consensus (more than 80%) was reached on both.CONCLUSION: a cross-sectional study by the Delphi method provided the opinions of a panel of experts on controversial issues in the surgical treatment of Crohn’s disease. Statements that reach consensus will be included by the working group in a new edition of clinical guidelines of Crohn’s disease.
{"title":"Consensus on controversial issues of the surgery for Crohn’s disease by Delphi method","authors":"Y. Shelygin, S. Achkasov, I. Reshetov, I. V. Mayev, O. Drapkina, E. Belousova, A. Vardanyan, B. Nanaeva, D. Abdulganieva, L. Adamyan, L. Namazova-Baranova, A. Razumovsky, A. Revishvili, I. Khatkov, A. Shabunin, M. Livzan, A. Sazhin, V. M. Timerbulatov, O. Khlynova, S. Yatsyk, R. Abdulkhakov, O. P. Alekseeva, S. Alekseenko, I. Bakulin, O. Barysheva, D. A. Blagovestnov, K. Bolikhov, V. Veselov, Y. Vinogradov, O. Golovenko, I. Gubonina, A. Gulyaev, A. Dolgushina, E. Dyakonova, T. Zhigalova, O. Karpukhin, O. Knyazev, N. V. Kostenko, I. D. Loranskaya, A. Moskalev, A. Odintsova, V. V. Omelyanovsky, M. Osipenko, V. Pavlenko, E. Poluektova, D. Popov, G. Rodoman, A. Segal, S. Sitkin, M. I. Skalinskaya, A. Surkov, L. V. Tarasova, Y. B. Uspenskaya, S. Frolov, E. Chashkova, S. Shapovalyants, O. Shifrin, O. Shcherbakova, O. Shchukina, T. Shkurko, I. Nazarov, A. Mingazov","doi":"10.33878/2073-7556-2023-22-2-172-183","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-2-172-183","url":null,"abstract":"AIM: to establish the consensus on controversial issues of the surgery for Сrohn’s disease by Delphi method.METHODS: a cross-sectional study was conducted by the Delphi method. 62 experts voted intramural and anonymous (31.03.23). 5 statements from the current edition of clinical guidelines were selected for correction by working group and further voting [2]. Based on the practical experience of the working group and literature data, 3 new statements were created also. Statements that do not reach the required level of agreement (80% or more) will be subjected to Round 2 of the Delphi method.RESULTS: all experts took part in the anonymous voting. The panel of experts is represented by 8 different areas of practical medicine and the median of the professional experience of the respondents was 30 (12–49) years. Of the 8 statements submitted for voting, consensus (80% or more) was reached on 6 out of 8. 2 statements have been revised by working group for the distance 2nd round of the Delphi study. Consensus (more than 80%) was reached on both.CONCLUSION: a cross-sectional study by the Delphi method provided the opinions of a panel of experts on controversial issues in the surgical treatment of Crohn’s disease. Statements that reach consensus will be included by the working group in a new edition of clinical guidelines of Crohn’s disease.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74329453","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 : 2023-06-21DOI: 10.33878/2073-7556-2023-22-2-40-48
D. Aleshin, S. Achkasov, O. Sushkov, D. Shakhmatov, E. Surovegin, O. Fomenko
PATIENTS AND METHODS: the retrospective study of clinical features and diagnostic tests results included 81 patients with idiopathic megacolon/megarectum (2004–2022). The diagnosis of megacolon/megarectum was confirmed with a barium enema, Hirschsprung’s disease was excluded based on anorectal manometry and (if needed) rectal Swenson biopsy. The QoL was assessed by IBSQOL questionnaire; clinical symptoms were assessed with a point scale.RESULTS: the quality of life in patients with idiopathic megacolon has most affected energy (emotional and physical) and physical role (work/main activity). In univariate analysis the significant correlation was revealed between QoL and age, sex, rate of defecation without assistance, rate of integral parameters “abdominal discomfort” and “defecation difficulties”, duration of anamnesis, Wexner constipation scale rate and gut transit time (p < 0,05). In the same time, the presence or absence of constipation or anal incontinence (leakage), colon and rectum sizes (based on barium enema), parameters of defecografy and rectal compliance test have not correlated with a QoL. No significant difference of QoL in patients added to conservative treatment and operated after. Due to multivariate analysis (multiple linear regression) the age and rate of “abdominal discomfort” and “defecation difficulties” were only independent factors affected quality of life.CONCLUSION: in terms of quality of life, idiopathic megacolon has the greatest impact on general tone and ability to perform basic professional activities. Independent factors that statistically significantly affect the assessment of quality of life are the age of patients and the severity of symptoms of abdominal discomfort and defecation disorders.
{"title":"Clinical features and quality of life of patients with idiopathic megacolon","authors":"D. Aleshin, S. Achkasov, O. Sushkov, D. Shakhmatov, E. Surovegin, O. Fomenko","doi":"10.33878/2073-7556-2023-22-2-40-48","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-2-40-48","url":null,"abstract":"PATIENTS AND METHODS: the retrospective study of clinical features and diagnostic tests results included 81 patients with idiopathic megacolon/megarectum (2004–2022). The diagnosis of megacolon/megarectum was confirmed with a barium enema, Hirschsprung’s disease was excluded based on anorectal manometry and (if needed) rectal Swenson biopsy. The QoL was assessed by IBSQOL questionnaire; clinical symptoms were assessed with a point scale.RESULTS: the quality of life in patients with idiopathic megacolon has most affected energy (emotional and physical) and physical role (work/main activity). In univariate analysis the significant correlation was revealed between QoL and age, sex, rate of defecation without assistance, rate of integral parameters “abdominal discomfort” and “defecation difficulties”, duration of anamnesis, Wexner constipation scale rate and gut transit time (p < 0,05). In the same time, the presence or absence of constipation or anal incontinence (leakage), colon and rectum sizes (based on barium enema), parameters of defecografy and rectal compliance test have not correlated with a QoL. No significant difference of QoL in patients added to conservative treatment and operated after. Due to multivariate analysis (multiple linear regression) the age and rate of “abdominal discomfort” and “defecation difficulties” were only independent factors affected quality of life.CONCLUSION: in terms of quality of life, idiopathic megacolon has the greatest impact on general tone and ability to perform basic professional activities. Independent factors that statistically significantly affect the assessment of quality of life are the age of patients and the severity of symptoms of abdominal discomfort and defecation disorders.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86402798","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 : 2023-06-04DOI: 10.33878/2073-7556-2023-22-2-118-124
N. Stepanova, V. Novozhilov, D. A. Zvonkov, I. Latynceva
The experience of complications treatment after surgery for Hirschsprung’s disease using posterior sagittal transanal approach is presented. It allows to obtain a sufficient overview of the main anatomical structures of the small pelvis in a “frozen pelvis” situation, helping to avoid their damage at the scar tissue changes.
{"title":"Treatment of complications after surgery for Hirschsprung’s disease using posterior sagittal transanal approach (clinical observation)","authors":"N. Stepanova, V. Novozhilov, D. A. Zvonkov, I. Latynceva","doi":"10.33878/2073-7556-2023-22-2-118-124","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-2-118-124","url":null,"abstract":"The experience of complications treatment after surgery for Hirschsprung’s disease using posterior sagittal transanal approach is presented. It allows to obtain a sufficient overview of the main anatomical structures of the small pelvis in a “frozen pelvis” situation, helping to avoid their damage at the scar tissue changes.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86766456","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 : 2023-06-03DOI: 10.33878/2073-7556-2023-22-2-10-31
S. Achkasov, Z. A. Bagatelia, S. Bagnenko, A. Belyaev, Y. Gevorkyan, V. L. Denisenko, I. I. Zatevakhin, A. Kaprin, A. Karachun, O. Kit, Z. Z. Mammedli, A. Moskalev, I. Nazarov, A. Revishvili, A. Sazhin, I. Stilidi, O. Sushkov, V. M. Timerbulatov, V. Totikov, V. S. Trifonov, A. Tyagunov, I. Khatkov, A. Shabunin, Y. Shelygin, P. Yartsev
.
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{"title":"Acute malignant colorectal obstruction (K56.6; C18, C19, C20), adults","authors":"S. Achkasov, Z. A. Bagatelia, S. Bagnenko, A. Belyaev, Y. Gevorkyan, V. L. Denisenko, I. I. Zatevakhin, A. Kaprin, A. Karachun, O. Kit, Z. Z. Mammedli, A. Moskalev, I. Nazarov, A. Revishvili, A. Sazhin, I. Stilidi, O. Sushkov, V. M. Timerbulatov, V. Totikov, V. S. Trifonov, A. Tyagunov, I. Khatkov, A. Shabunin, Y. Shelygin, P. Yartsev","doi":"10.33878/2073-7556-2023-22-2-10-31","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-2-10-31","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83241449","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 : 2023-03-21DOI: 10.33878/2073-7556-2023-22-1-83-90
A. Vardanyan, I. S. Anosov, V. A. Michalchenko, B. Nanaeva
AIM: to evaluate the effect of intestinal anastomosis type on risk of Crohn’s disease (CD) recurrence.PATIENTS AND METHODS: the retrospective cohort study included 130 patients with CD who underwent surgery for a complicated CD in 2012–2017. Ileocecal resection with anastomosis was performed in 112/130 (86.2%) patients. Resection of the terminal ileum with resection of the right side of the colon with the formation of an ileo-transverse anastomosis. In 18/130 (13.2%) cases. Stapled “side-to-side” anastomosis was formed in 57/130 (43.8%) patients, while hand sewn “end-to-end” — in 73/130 (56.2%) patients. Post-op complications occurred in 21/130 (16.2%) cases. After surgery, most patients were treated by azathioprine as an anti-recurrence therapy — 112/130 (86.2%) patients, while in 31/112 (23.8%) cases, additional biological therapy was done. In 14/130 (10.7%) patients, anti-recurrence therapy was carried out in mono mode with a biological drug.RESULTS: mean follow-up was 28.5 (1.9–95.4) months. Recurrence occurred in 54/130 (41.5%) patients on average 18 ± 5 (12–41) months after surgery. Thus, the operative time exceeding 200 minutes was significantly associated with an increase in the recurrence rate (p = 0.03). It was found that the type of anastomosis does not affect the recurrence risk. Moreover, among the significant factors was the operative time. It increases the chance of recurrence by 2.9 times in the univariate model (p < 0.05), and in the multivariate model — by 6.3 times, when exceeding 155 minutes.CONCLUSION: the type of anastomosis does not affect the recurrence risk. The operation time exceeding 155 minutes increases the chance of recurrence by 6 times (p < 0.01).
{"title":"Does the type of anastomosis affect the risk of recurrence in Crohn disease?","authors":"A. Vardanyan, I. S. Anosov, V. A. Michalchenko, B. Nanaeva","doi":"10.33878/2073-7556-2023-22-1-83-90","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-1-83-90","url":null,"abstract":"AIM: to evaluate the effect of intestinal anastomosis type on risk of Crohn’s disease (CD) recurrence.PATIENTS AND METHODS: the retrospective cohort study included 130 patients with CD who underwent surgery for a complicated CD in 2012–2017. Ileocecal resection with anastomosis was performed in 112/130 (86.2%) patients. Resection of the terminal ileum with resection of the right side of the colon with the formation of an ileo-transverse anastomosis. In 18/130 (13.2%) cases. Stapled “side-to-side” anastomosis was formed in 57/130 (43.8%) patients, while hand sewn “end-to-end” — in 73/130 (56.2%) patients. Post-op complications occurred in 21/130 (16.2%) cases. After surgery, most patients were treated by azathioprine as an anti-recurrence therapy — 112/130 (86.2%) patients, while in 31/112 (23.8%) cases, additional biological therapy was done. In 14/130 (10.7%) patients, anti-recurrence therapy was carried out in mono mode with a biological drug.RESULTS: mean follow-up was 28.5 (1.9–95.4) months. Recurrence occurred in 54/130 (41.5%) patients on average 18 ± 5 (12–41) months after surgery. Thus, the operative time exceeding 200 minutes was significantly associated with an increase in the recurrence rate (p = 0.03). It was found that the type of anastomosis does not affect the recurrence risk. Moreover, among the significant factors was the operative time. It increases the chance of recurrence by 2.9 times in the univariate model (p < 0.05), and in the multivariate model — by 6.3 times, when exceeding 155 minutes.CONCLUSION: the type of anastomosis does not affect the recurrence risk. The operation time exceeding 155 minutes increases the chance of recurrence by 6 times (p < 0.01).","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81063134","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 : 2023-03-21DOI: 10.33878/2073-7556-2023-22-1-45-53
A. Mingazov, A. Vardanyan, O. Sushkov, D. G. Shahmatov, B. Nanaeva, T. Baranova, S. Katorkin, N. V. Kostenko, S. Achkasov
AIM: to improve the results of treatment of patients with «extremely severe» ulcerative colitis (UC).PATIENTS AND METHODS: A multicenter observational prospective «case-control» study was conducted. The study included 71 patients with «extremely» severe UC from June 2019 to October 2021. All patients underwent conservative therapy in accordance with current clinical guidelines. Evaluation of the effectiveness of treatment was carried out on the 3rd and 7th days of therapy, a "response" or "no response" to steroid therapy was stated.RESULTS: A total of 48 (68%) patients underwent surgical treatment during the follow-up period during hospitalization. 23 (32%) patients "responded" to conservative therapy and were discharged without colectomy. A reliable independent predictor of colectomy at the time of hospitalization was the level of albumin less than 29 g/l (OR – 8,6 95% CI: 2,5 – 39,9, p=0,002). On day 3, the reliable predictors were the level of C-reactive protein over 15.5 mg/l (OR – 9 95% CI: 2.4 – 46.1, p=0.003) and the value of the Mayo index above 7 points (OR – 13.3 95% CI: 3.3 – 75.7, p=0.0009).CONCLUSION: The study has demonstrated that the only reliable and independent predictor of colectomy at admission to the clinic is the level of albumin less than 29 g/l. Reliable factors that make it possible to evaluate and predict the effectiveness of therapy are the level of C-reactive protein more than 15.5 mg/l and the value of the Mayo index above 7 points on the 3rd day of therapy, as well as the level of C-reactive protein above 29 mg/l on the 7th day.
{"title":"Results of multicenter observational study «predictors of colectomy in patients with extremely severe ulcerative colitis","authors":"A. Mingazov, A. Vardanyan, O. Sushkov, D. G. Shahmatov, B. Nanaeva, T. Baranova, S. Katorkin, N. V. Kostenko, S. Achkasov","doi":"10.33878/2073-7556-2023-22-1-45-53","DOIUrl":"https://doi.org/10.33878/2073-7556-2023-22-1-45-53","url":null,"abstract":"AIM: to improve the results of treatment of patients with «extremely severe» ulcerative colitis (UC).PATIENTS AND METHODS: A multicenter observational prospective «case-control» study was conducted. The study included 71 patients with «extremely» severe UC from June 2019 to October 2021. All patients underwent conservative therapy in accordance with current clinical guidelines. Evaluation of the effectiveness of treatment was carried out on the 3rd and 7th days of therapy, a \"response\" or \"no response\" to steroid therapy was stated.RESULTS: A total of 48 (68%) patients underwent surgical treatment during the follow-up period during hospitalization. 23 (32%) patients \"responded\" to conservative therapy and were discharged without colectomy. A reliable independent predictor of colectomy at the time of hospitalization was the level of albumin less than 29 g/l (OR – 8,6 95% CI: 2,5 – 39,9, p=0,002). On day 3, the reliable predictors were the level of C-reactive protein over 15.5 mg/l (OR – 9 95% CI: 2.4 – 46.1, p=0.003) and the value of the Mayo index above 7 points (OR – 13.3 95% CI: 3.3 – 75.7, p=0.0009).CONCLUSION: The study has demonstrated that the only reliable and independent predictor of colectomy at admission to the clinic is the level of albumin less than 29 g/l. Reliable factors that make it possible to evaluate and predict the effectiveness of therapy are the level of C-reactive protein more than 15.5 mg/l and the value of the Mayo index above 7 points on the 3rd day of therapy, as well as the level of C-reactive protein above 29 mg/l on the 7th day.","PeriodicalId":17840,"journal":{"name":"Koloproktologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87873364","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 : 2023-03-21DOI: 10.33878/2073-7556-2023-22-1-99-107
I. Tishaeva, O. Knyazev, T. Baranova, D. Podolskaya, T. Alexandrov, B. Nanaeva
AIM: detection of steroid dependence and steroid resistance predictors in patients with ulcerative colitis (UC).PATIENTS AND METHODS: a retrospective study was conducted. The medical documentation of 1105 patients, who underwent inpatient treatment in Ryzhikh National Medical Research Center of Coloproctology from 2018 to 2021, were analyzed. 69% of patients (n=762) received systemic steroid therapy for UC. In accordance with inclusion and non-inclusion criteria, the medical documentation of 170 patients was selected for statistical analysis. Depending on the steroid status of patients, three groups were identified: group 1 (n=56) with steroid dependence, group 2 (n=56) with steroid resistance and group 3 - control (n=58), who were prescribed systemic GCS without the further development of steroid dependence and resistance.RESULTS: the incidence of steroid dependence was 23.4% (n=259), and steroid resistance was 15.2% (n=168). We identified the following predictors and risk factors of steroid dependence: age of the disease onset <30 y.o. (AOR=0,960, 95%CI= 0,928-0,993, p=0,019), start dose of prednisolone <60 mg (AOR=2,369, 95%ДИ= 1,030-5,441, p=0,042), prescription of systemic GCS ≥2 courses per year (AOR=2,988, 95%ДИ= 1,349-6,619, p=0,007), Mayo Index Score <10 (AOR=0,631, 95%ДИ=0,492-0,809, p<0,001). The risk of steroid resistance statistically significant when Mayo Index Score ≥10 (AOR=2,573, 95%ДИ=1,094-6,050, p=0,030), albumin level <37,1 g/l (AOR=4,571, 95%ДИ=1,567-13,330, p=0,005), CRP ≥47,1 mg/l (AOR=2,641, 95%ДИ=1,102-6,328, p=0,029).CONCLUSION: it is rational to predict an individual response to GCS in patients with UC. With a high risk of developing steroid dependence and steroid resistance, it is advisable to consider early appointment of biological and target therapy, avoiding represcription of GCS.
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