<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">gnck</journal-id><journal-title-group><journal-title xml:lang="ru">Колопроктология</journal-title><trans-title-group xml:lang="en"><trans-title>Koloproktologia</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2073-7556</issn><issn pub-type="epub">2686-7303</issn><publisher><publisher-name>Russian Association of Coloproctology</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.33878/2073-7556-2019-18-3-77-83</article-id><article-id custom-type="elpub" pub-id-type="custom">gnck-1506</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CASE REPORT</subject></subj-group></article-categories><title-group><article-title>СТРИКТУРОПЛАСТИКА В КАЧЕСТВЕ ОРГАНОСОХРАНЯЮЩЕЙ МЕТОДИКИ У ПАЦИЕНТОВ C БОЛЕЗНЬЮ КРОНА ТОНКОЙ КИШКИ (клинический случай)</article-title><trans-title-group xml:lang="en"><trans-title>STRICTUREPLASTY AS AN ORGAN-SAVING METHOD IN PATIENTS WITH SMALL BOWEL CROHN'S DISEASE (case report)</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Варданян</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Vardanyan</surname><given-names>A. V.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тобоева</surname><given-names>М. Х.</given-names></name><name name-style="western" xml:lang="en"><surname>Toboeva</surname><given-names>M. Kh.</given-names></name></name-alternatives><email xlink:type="simple">rita.toboeva@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Зароднюк</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Zarodnyuk</surname><given-names>I. V.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Орлова</surname><given-names>Л. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Orlova</surname><given-names>L. P.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУ «ГНЦК им. А.Н. Рыжих» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>State Scientific Centre of Coloproctology of the Ministry of Healthcare of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2019</year></pub-date><pub-date pub-type="epub"><day>23</day><month>08</month><year>2019</year></pub-date><volume>18</volume><issue>3(69)</issue><fpage>77</fpage><lpage>83</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Варданян А.В., Тобоева М.Х., Зароднюк И.В., Орлова Л.П., 2019</copyright-statement><copyright-year>2019</copyright-year><copyright-holder xml:lang="ru">Варданян А.В., Тобоева М.Х., Зароднюк И.В., Орлова Л.П.</copyright-holder><copyright-holder xml:lang="en">Vardanyan A.V., Toboeva M.K., Zarodnyuk I.V., Orlova L.P.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.ruproctology.com/jour/article/view/1506">https://www.ruproctology.com/jour/article/view/1506</self-uri><abstract><p>Болезнь Крона (БК) – это хроническое рецидивирующее заболевание, характеризующееся трансмуральным, сегментарным, гранулематозным воспалением во всех отделах желудочно-кишечного тракта от ротовой полости до перианальной области с развитием местных и системных осложнений. Заболевание имеет тенденцию к прогрессированию, несмотря на широкий спектр современных консервативных и хирургических мероприятий. Одной из наиболее частых причин хирургического вмешательства при БК являются стриктуры в различных отделах желудочно-кишечного тракта (ЖКТ), формирующиеся в результате длительного неспецифического воспаления, а в дальнейшем и рубцовых изменений кишечной стенки. Возникновение стриктур является серьезной клинической проблемой, обусловленной отсутствием эффективных методов ранней диагностики и лечения. Фактически, оперативное лечение подразделяется на два вида – резекция пораженного участка и органосохраняющие вмешательства. При этом, выполнение обширных резекций тонкой кишки приводит к потере большой части абсорбционной поверхности и развитию серьезного осложнения – синдрома короткой кишки. В этой связи, за рубежом в определенных ситуациях отдаётся предпочтение органосохраняющей операции – стриктуропластике. В этой статье мы представляем случай успешного применения данной методики у пациента с осложненной формой болезни Крона.</p></abstract><trans-abstract xml:lang="en"><p>Crohn's disease (CD) is a complex, chronic recurrent disease with transmural, segmental, granulomatous inflammation in all parts of the gastrointestinal tract with high risk of local and systemic complications. The disease is progressive, despite a wide range of modern conservative and surgical approaches. One of the most common causes of surgery for CD is strictures, which are result of prolonged, non-specific inflammation and later cicatricial changes in the intestinal wall. The occurrence of strictures is a serious clinical problem, due to the lack of effective methods of diagnosis and treatment. In fact, there are two type of surgery – resection of the affected area and organ-saving procedure. At the same time, when performing extensive resections of the small bowel, the patient loses a large area of absorption surface, which often leads to the short bowel syndrome. Recently, the majority of foreign experts prefer organ-saving procedure – strictureplasty. In this paper, we present a case of successful application of this procedure for complicated form of Crohn's disease.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>болезнь Крона</kwd><kwd>стриктуропластика</kwd><kwd>Heineke-Mikulicz</kwd></kwd-group><kwd-group xml:lang="en"><kwd>Crohn's disease</kwd><kwd>strictureplasty</kwd><kwd>Heineke-Mikulicz</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Халиф И.Л., Варданян А.В., Шапина М.В. и соавт. Противорецидивная терапия болезни Крона в послеоперационном периоде. Обзор литературы. Колопроктология. 2017; № 3(61), с. 63-70.</mixed-citation><mixed-citation xml:lang="en">Khalif I.L., Vardanyan A.V., Shapina M.V. et al. Anti-relapse therapy of Crohn’s disease in the postoperative period. Literature review. Koloproktologia. 2017; No. 3 (61), pp. 63-70. (in Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Шелыгин Ю.А., Кашников В.Н., Болихов К.В., Варданян А.В. Предикторы эффективности илеостомии при осложненных формах болезни Крона толстой кишки. Анналы хирургии. 2012; № 3, с. 37-42.</mixed-citation><mixed-citation xml:lang="en">Shelygin Yu.A., Kashnikov V.N., Bolikhov K.V., Vardanyan A.V. Predictors of ileostomy efficacy in complicated forms of Crohn’s disease of the colon. Annals of surgery. 2012; No. 3, p. 37-42. (in Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Шелыгин Ю.А. Клинические рекомендации. Колопроктология. 2019; № 1, с. 7-38.</mixed-citation><mixed-citation xml:lang="en">Shelygin Yu.A. Clinical guidelines. Koloproktologia. 2019; № 1, с. 7-38. (in Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Варданян А.В., Кашников В.Н., Болихов К.В. и соавт. Лапароскопическая илеостомия при болезни Крона. Колопроктология. 2011; № 3, с. 20-23.</mixed-citation><mixed-citation xml:lang="en">Vardanyan A.V., Kashnikov V.N., Bolikhov K.V. et al. Laparoscopic ileostomy for Crohn’s disease. Koloproktologia. 2011; № 3, p. 20-23. (in Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Шелыгин Ю.А., Кашников В.Н., Болихов К.В., Варданян А.В. Илеостомия и ее эффективность при осложненных формах болезни Крона толстой кишки. Вестник северо-западного государственного медицинского университета им. И.И. Мечникова. 2012; т. 4, № 3, с. 19-23.</mixed-citation><mixed-citation xml:lang="en">Shelygin Yu.A., Kashnikov V.N., Bolikhov K.V., Vardanyan A.V. Ileostomy and its effectiveness in complicated forms of Crohn’s disease of the colon. Bulletin of the North-West State Medical University. I.I. Mechnikova. 2012; v. 4, no. 3, pp. 19-23. (in Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Шелыгин Ю.А., Ачкасов С.И., Кашников В.Н. и соавт. Единый лапароскопический доступ при многоэтапном хирургическом лечении пациента с язвенным колитом. Колопроктология. 2013; № 3(45), с. 30-31.</mixed-citation><mixed-citation xml:lang="en">Shelygin Yu.A., Achkasov S.I., Kashnikov V.N. et al. Single laparoscopic access in the multi-stage surgical treatment of a patient with ulcerative colitis. Koloproktologia. 2013; no. 3(45), pp. 30-31. (in Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Шелыгин Ю.А., Кашников В.Н., Болихов К.В. и соавт. Эффективность илеостомии при болезни Крона толстой кишки с перианальными поражениями. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2011; т. 21, № 6, с. 64-68.</mixed-citation><mixed-citation xml:lang="en">Shelygin Yu.A., Kashnikov V.N., Bolikhov K.V. et al. Efficacy of ileostomy in Crohn’s disease of the colon with perianal lesions. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2011; v. 21, no. 6, pp. 64-68. (in Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Strong SA, Koltun WA, Hyman NH et al. Standards Practice Task Force of the American Society of Colon and Rectal Surgeons. Practice parameters for the surgical management of Crohn’s disease. Dis. Colon Rectum. 2007;50:1735-1746. https://doi.org/10.1007/s10350-007-9012-7</mixed-citation><mixed-citation xml:lang="en">Strong SA, Koltun WA, Hyman NH et al. Standards Practice Task Force of the American Society of Colon and Rectal Surgeons. Practice parameters for the surgical management of Crohn’s disease. Dis. Colon Rectum. 2007;50:1735-1746. https://doi.org/10.1007/ s10350-007-9012-7</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Frolkis AD, Dykeman J, Negron ME, et al. Risk of surgery for inflammatory bowel diseases has decreased over time: a systematic review and meta-analysis of population-based studies. Gastroenterology 2013;145(5):996–1006. https://doi.org/10.1053/j. gastro.2013.07.041</mixed-citation><mixed-citation xml:lang="en">Frolkis AD, Dykeman J, Negron ME, et al. Risk of surgery for inflammatory bowel diseases has decreased over time: a systematic review and meta-analysis of population-based studies. Gastroenterology 2013;145(5):996–1006. https://doi.org/10.1053/j. gastro.2013.07.041</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Kariyawasam VC, Selinger CP, Katelaris PH, et al. Early use of thiopurines or methotrexate reduces major abdominal and perianal surgery in Crohn’s disease. Inflamm Bowel Dis. 2014;20:1382-1390. https://doi.org/10.1097/MIB.0000000000000119</mixed-citation><mixed-citation xml:lang="en">Kariyawasam VC, Selinger CP, Katelaris PH, et al. Early use of thiopurines or methotrexate reduces major abdominal and perianal surgery in Crohn’s disease. Inflamm Bowel Dis. 2014;20:1382-1390. https://doi.org/10.1097/MIB.0000000000000119</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Toh JWT, Wang N., Young CJ et al. Major Abdominal and Perianal Surgery in Crohn’s Disease: Long-term Follow-up of Australian Patients With Crohn’s Disease. Dis Colon Rectum. 2018;61(1):67-76. https://doi.org/10.1097/DCR.0000000000000975</mixed-citation><mixed-citation xml:lang="en">Toh JWT, Wang N, Young CJ et al. Major Abdominal and Perianal Surgery in Crohn’s Disease: Long-term Follow-up of Australian Patients With Crohn’s Disease. Dis Colon Rectum. 2018;61(1):67-76. https://doi.org/10.1097/DCR.0000000000000975</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Frolkis AD, Lipton DS, Fiest KM, et al.Cumulative incidence of second intestinal resection in Crohn’s disease: a systematic review and meta-analysis of population-based studies. Am J Gastroenterol. 2014;109(11):1739-48. https://doi.org/10.1038/ajg.2014.297</mixed-citation><mixed-citation xml:lang="en">Frolkis AD, Lipton DS, Fiest KM, et al.Cumulative incidence of second intestinal resection in Crohn’s disease: a systematic review and meta-analysis of population-based studies. Am J Gastroenterol. 2014;109(11):1739-48. https://doi.org/10.1038/ajg.2014.297</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Roy P, Kumar D. Strictureplasty. Br J Surg. 2004;91:1428-1437. https://doi.org/10.1002/bjs.4804</mixed-citation><mixed-citation xml:lang="en">Roy P., Kumar D. Strictureplasty. Br J Surg. 2004;91:1428– 1437. https://doi.org/10.1002/bjs.4804</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Lee EC, Papaioannou N, Ann R. Minimal surgery for chronic obstruction in patients with extensive or universal Crohn’s disease. Coll Surg Engl. 1982;64:229–233</mixed-citation><mixed-citation xml:lang="en">Lee EC, Papaioannou N., Ann R. Minimal surgery for chronic obstruction in patients with extensive or universal Crohn’s disease. Coll Surg Engl.1982;64:229–233</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Alexander-Williams J. The technique of intestinal strictureplasty. Colorectal Dis. 1986;1(54):7.</mixed-citation><mixed-citation xml:lang="en">Alexander-Williams J. The technique of intestinal strictureplasty. Colorectal Dis. 1986;1(54):7.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Tonelli F, Alemanno G, Di Martino C, et al. Results of surgical treatment for jejunal Crohn’s disease: choice between resection, strictureplasty, and combined treatment. Langenbecks Arch Surg. 2017;402(7):1071-1078. https://doi.org/10.1007/s00423-016-1497-x</mixed-citation><mixed-citation xml:lang="en">Tonelli F, Alemanno G, Di Martino C, et al. Results of surgical treatment for jejunal Crohn’s disease: choice between resection, strictureplasty, and combined treatment. Langenbecks Arch Surg. 2017;402(7):1071-1078. https://doi.org/10.1007/s00423-016-1497-x</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Yamamoto T, Fazio VW, Tekkis PP. Safety and efficacy of strictureplasty for Crohn’s disease: a systematic review and meta-analysis. Dis Colon Rectum. 2007;50:1968–1986. https://doi. org/10.1007/s10350-007-0279-5</mixed-citation><mixed-citation xml:lang="en">Yamamoto T, Fazio VW, Tekkis PP. Safety and efficacy of strictureplasty for Crohn’s disease: a systematic review and meta-analysis. Dis Colon Rectum. 2007;50:1968–1986. https://doi. org/10.1007/s10350-007-0279-5</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Rottoli M, Vallicelli C et al. Predictors of early recurrence after strictureplasty for Crohn’s disease of the small bowel during the years of biologics. Dig Liver Dis. 2018 Dec 8. pii: S1590-8658(18)31266-0. https://doi.org/10.1016/j.dld.2018.11.027</mixed-citation><mixed-citation xml:lang="en">Rottoli M, Vallicelli C et al. Predictors of early recurrence after strictureplasty for Crohn’s disease of the small bowel during the years of biologics. Dig Liver Dis. 2018 Dec 8. pii: S1590-8658(18)31266-0. https://doi.org/10.1016/j.dld.2018.11.027</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Mege D, Panis Y. Unmet Therapeutic Needs: Focus on Intestinal Fibrosis Surgical Approach: Resection, Strictureplasty and Others. Dig Dis. 2017;35(1-2):38-44. https://doi.org/10.1159/000449081</mixed-citation><mixed-citation xml:lang="en">Mege D, Panis Y. Unmet Therapeutic Needs: Focus on Intestinal Fibrosis Surgical Approach: Resection, Strictureplasty and Others. Dig Dis. 2017;35(1-2):38-44. https://doi.org/10.1159/000449081</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Maguire LH, Alavi K et al. Surgical Considerations in the Treatment of Small Bowel Crohn’s Disease. J Gastrointest Surg. 2017 Feb;21(2):398-411. https://doi.org/10.1007/s11605-016-3330-9</mixed-citation><mixed-citation xml:lang="en">Maguire LH, Alavi K et al. Surgical Considerations in the Treatment of Small Bowel Crohn’s Disease. J Gastrointest Surg. 2017 Feb;21(2):398-411. https://doi.org/10.1007/s11605-016-3330-9</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
