gnckКолопроктологияKoloproktologia2073-75562686-7303Russian Association of Coloproctology10.33878/2073-7556-2022-21-3-43-51gnck-1722Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESНепосредственные и отдаленные результаты лечения стриктур толстокишечных анастомозов методами баллонной дилатации и электродеструкцииBalloon dilation and electrodestruction for colorectal anastomosis strictureshttps://orcid.org/0000-0003-3597-4326КачановаТ. В.KachanovaT. V.

Качанова Татьяна Владимировна

ул. Саляма Адиля, д. 2, г. Москва, 123423тел. (499)199-00-68

Tatiana V. Kachanova

Salyama Adilya str., 2, Moscow, 123423

ka4anova91@mail.ruhttps://orcid.org/0000-0001-9992-119XВеселовВ. В.VeselovV. V.

ул. Саляма Адиля, д. 2, г. Москва, 123423

Viktor V. Veselov

Salyama Adilya str., 2, Moscow, 123423

https://orcid.org/0000-0003-4872-4481ВагановЮ. Е.VaganovYu. E.

ул. Саляма Адиля, д. 2, г. Москва, 123423

Yuri E. Vaganov

Salyama Adilya str., 2, Moscow, 123423

https://orcid.org/0000-0002-4558-560XМингазовА. Ф.MingazovA. F.

ул. Саляма Адиля, д. 2, г. Москва, 123423

Airat F. Mingazov

Salyama Adilya str., 2, Moscow, 123423

https://orcid.org/0000-0001-7964-2126ШахматовД. Г.ShakhmatovD. G.

ул. Саляма Адиля, д. 2, г. Москва, 123423

Dmitrii G. Shakhmatov

Salyama Adilya str., 2, Moscow, 123423

https://orcid.org/0000-0001-5848-4050ЛикутовА. А.LikutovA. A.

ул. Саляма Адиля, д. 2, г. Москва, 123423

Aleksei A. Likutov

Salyama Adilya str., 2, Moscow, 123423

https://orcid.org/0000-0002-6212-9454ЧернышовС. В.ChernyshovS. V.

ул. Саляма Адиля, д. 2, г. Москва, 123423

Stanislav V. Chernyshov

Salyama Adilya str., 2, Moscow, 123423

https://orcid.org/0000-0001-9780-7916СушковО. И.SushkovO. I.

ул. Саляма Адиля, д. 2, г. Москва, 123423

Oleg I. Sushkov

Salyama Adilya str., 2, Moscow, 123423

ФГБУ «НМИЦ колопроктологии имени А.Н. Рыжих» Минздрава РоссииРоссияRyzhikh National Medical Research Center of ColoproctologyRussian Federation2022210920222134351Copyright © Качанова Т.В., Веселов В.В., Ваганов Ю.Е., Мингазов А.Ф., Шахматов Д.Г., Ликутов А.А., Чернышов С.В., Сушков О.И., 20222022Качанова Т.В., Веселов В.В., Ваганов Ю.Е., Мингазов А.Ф., Шахматов Д.Г., Ликутов А.А., Чернышов С.В., Сушков О.И.Kachanova T.V., Veselov V.V., Vaganov Y.E., Mingazov A.F., Shakhmatov D.G., Likutov A.A., Chernyshov S.V., Sushkov O.I.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/1722ЦЕЛЬ

ЦЕЛЬ: изучить непосредственные и отдаленные результаты лечения стриктур толстокишечных анастомозов при помощи баллонной дилатации (БД) и электродеструкции (ЭД).

ПАЦИЕНТЫ И МЕТОДЫ

ПАЦИЕНТЫ И МЕТОДЫ: в анализ включены 69 пациентов, у которых с сентября 2014 по декабрь 2021 гг. проводилось эндоскопическое лечение, направленное на ликвидацию стриктур толстокишечных анастомозов. 32 больным была выполнена эндоскопическая баллонная дилатация, 37 — электродеструкция стриктур.

РЕЗУЛЬТАТЫ

РЕЗУЛЬТАТЫ: анализ непосредственных результатов применения БД и ЭД показал, что расширить просвет кишки в области стриктуры до целевых значений удалось у всех больных. При оценке отдаленных результатов лечения установлено, что вероятность возникновения рецидива стриктуры толстокишечного анастомоза в группе БД в 3 раза выше, чем после электродеструкции стриктуры (ОШ = 2,9; 95% ДИ: 0,7–11,1; р = 0,04). При многофакторном анализе независимым фактором, значительно повышающим риск развития рецидива стриктуры, оказалась протяженность рубцового сужения более 11 мм (ОШ = 11,8; 95% ДИ: 1,57–123,5; р = 0,02).

ЗАКЛЮЧЕНИЕ

ЗАКЛЮЧЕНИЕ: электродеструкция и баллонная дилатация являются эффективными и безопасными методами эндоскопического лечения стриктур колоректальных анастомозов. Независимым фактором, повышающим риск развития рецидива стриктуры толстокишечного анастомоза, является протяженность рубцового сужения более 11 мм.

AIM

AIM: to assess results of balloon dilatation (BD) and electric destruction (ED) for strictures of colorectal anastomoses.

PATIENTS AND METHODS

PATIENTS AND METHODS: the prospective cohort study included 69 patients with colorectal anastomotic strictures. Thirty-two of them underwent endoscopic balloon dilatation, 37 — electric destruction of scar tissue using a spherical monopolar electrode.

RESULTS

RESULTS: the recurrence rate of the anastomotic stricture in the BD group was 3 times higher than after ED (OR = 2.9; 95% CI: 0.7–11.1; p = 0.04). The independent factor of stricture recurrence was the extent of stricture > 11 mm (OR = 11.8; 95% CI: 1,57–123,5; p = 0.02).

CONCLUSION

CONCLUSION: electric destruction and balloon dilatation are effective and safe methods for strictures of colorectal anastomoses. The independent factor recurrence risk of the stricture was the extent of the scar narrowing more than 11 mm long.

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