gnckКолопроктологияKoloproktologia2073-75562686-7303Russian Association of Coloproctology10.33878/2073-7556-2022-21-2-122-131gnck-1677Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWЭффективность и безопасность лапароскопической вентральной ректопексии сетчатым имплантом (систематический обзор)Efficiency and safety of laparoscopic ventral mesh rectopexy (a systematic review)https://orcid.org/0000-0002-2108-2362ХитарьянА. Г.KhitaryanA. G.

д. м. н., проф., зав. кафедрой, заведующий отделением

ЧУЗ «Клиническая больница «РЖД-Медицина»

кафедра хирургических болезней № 3

хирургическое отделение

344022

пер. Нахичеванский, д. 29

344011

ул. Варфоломеева, д. 92а

Ростов-на-Дону

Alexander G. Khitaryan

Department of Surgical Diseases № 3

344022

Nakhichevansky lane, 29

344011

Varfolomeeva street, 92a

Rostov-on-Don

khitaryan@gmail.comhttps://orcid.org/0000-0001-5647-1192ГоловинаА. А.GolovinaA. A.

врач-хирург, аспирант

кафедра хирургических болезней № 3

344022

пер. Нахичеванский, д. 29

344011

ул. Варфоломеева, д. 92а

Ростов-на-Дону

Anastasia A. Golovina

Department of Surgical Diseases № 3

344022

Nakhichevansky lane, 29

344011

Varfolomeeva street, 92a

Rostov-on-Don

https://orcid.org/0000-0001-7697-3384КовалевС. А.KovalevS. A.

к. м. н., доцент

кафедра хирургических болезней № 3

344022

пер. Нахичеванский, д. 29

344011

ул. Варфоломеева, д. 92а

Ростов-на-Дону

Sergey A. Kovalev

Department of Surgical Diseases № 3

344022

Nakhichevansky lane, 29

344011

Varfolomeeva street, 92a

Rostov-on-Don

https://orcid.org/0000-0002-4549-0643БурцевС. С.BurtsevS. S.

ординатор

кафедра хирургических болезней № 3

344022

пер. Нахичеванский, д. 29

344011

ул. Варфоломеева, д. 92а

Ростов-на-Дону

Spartak S. Burtsev

Department of Surgical Diseases № 3

344022

Nakhichevansky lane, 29

Rostov-on-Don

ФГБОУ ВО «Ростовский государственный медицинский университет» ; ЧУЗ «Клиническая больница «РЖД-Медицина»РоссияFSBEI HE “Rostov State Medical University”; Private Healthcare Institution “Clinical Hospital” Russian Railways-Medicine”Russian FederationФГБОУ ВО «Ростовский государственный медицинский университет» ; ЧУЗ «Клиническая больница «РЖД-Медицина»РоссияFSBEI HE “Rostov State Medical University”Russian Federation202221062022212122131Copyright © Хитарьян А.Г., Головина А.А., Ковалев С.А., Бурцев С.С., 20222022Хитарьян А.Г., Головина А.А., Ковалев С.А., Бурцев С.С.Khitaryan A.G., Golovina A.A., Kovalev S.A., Burtsev S.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ruproctology.com/jour/article/view/1677

   Цель исследования: изучение эффективности и безопасности метода лапароскопической вентральной ректопексии сетчатым имплантом в лечении пациентов с ректоцеле и выпадением прямой кишки.   Материалы и методы: нами был проведен систематический обзор литературы по эффективности и безопасности лапароскопической вентральной ректопексии у пациентов с ректоцеле и/или выпадением прямой кишки. После составления поискового запроса в базах данных PubMed, MEDLINE, EMBASE, Scopus, Cochrane library, CENTRAL, ISI Web of Science и eLibrary было найдено 2716 публикаций. Из них по критериям включения в обзор было отобрано 34 работы с общим числом прооперированных пациентов — 2101 человек.   Результаты: период наблюдения за пациентами после проведения оперативного лечения варьировал от 12 до 74 месяцев (среднее — 30,1 мес.). В 20 из 34 исследований средний возраст пациентов был более 60 лет, и, в среднем, составил 62,1 год. Среднее время операции составило 122,3 мин. (от 85 до 200 минут). Среди проанализированных работ общее число осложнений составило 138 (6,5 %) пациентов. Рецидив заболевания наблюдался в 4,1 % случаев от общего числа включенных больных. Значительное улучшение симптомов обструктивной дефекации отмечено в 79,6 % наблюдений.   Выводы: лапароскопическая вентральная ректопексия является эффективной методикой коррекции пролапса заднего компартмента тазового дна в отношении как анатомических, так и функциональных результатов, безопасной и имеет низкий риск возникновения осложнений. Однако требуется проведение дальнейших исследований по разработке показаний для применения данного вмешательства в качестве «операции выбора».

   Aim

   Aim:  to assess the efficacy and safety of laparoscopic ventral mesh rectopexy in patients with rectocele and rectal prolapse.   Materials and methods: a systematic review of the literature on the efficacy and safety of laparoscopic ventral mesh rectopexy in patients with rectocele and/or rectal prolapse. After compiling a search query, 2716 publications were found in the PubMed, MEDLINE, EMBASE, Scopus, Cochrane library, CENTRAL, ISI Web of Science and eLibrary databases. Twenty-four papers were selected according to the inclusion criteria for the review, with a total number of 2101 operated patients.

   Results

   Results: the follow up period after surgery ranged 30.1 (12-74) months. In 20 of 34 studies, the median age of patients was over 60 years, with a median of 62.1 years. The mean operative time was 122.3 minutes (85 to 200 minutes). Complications were revealed in 138 patients (6.5 % observations), recurrence — in 4.1 %. A significant improvement in the symptoms of obstructive defecation was noted in 79.6 %.   Conclusion: laparoscopic ventral mesh rectopexy is an effective method for posterior pelvic floor compartment prolapse in terms of both anatomical and functional results. It is safe and has a low risk of complications. However, further research is required to develop indications for the use of this proctdure as a “gold standard”.

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The authors declare that there are no conflicts of interest present.