Treatment of colon perforations after laparoscopic shaving of endometrioid foci of the colon (case report)
https://doi.org/10.33878/2073-7556-2025-24-1-62-71
Abstract
A clinical case of treatment of a 24-year-old patient D. with perforations of the colon and widespread fecal peritonitis after laparoscopic shaving of extragenital foci of the sigmoid and rectum is described. This clinical case demonstrates the possibility of using the laparoscopic method for colon perforation and advanced peritonitis. Reducing the volume of surgical aggression it contributed to the early rehabilitation of the patient and was not accompanied by complications. The use of programmatic sanitation laparoscopy in abdominal sepsis made it possible to avoid the formation of laparostoma, which later allowed reconstructive surgery to be performed using the laparoscopic method.
About the Authors
A. S. Arutyunyan
N.V. Sklifosovsky Research Institute of Emergency Care of the Department of Health of the City of Moscow
Russian Federation
Russian Federation
Anzhelika S. Arutyunyan
Author ID:1077406, Scopus Author ID: 57799224700, Researcher ID: MBG-9336-2025
B. Sukharevskaya sq., 3, Moscow, 129090, tel.: +7 (909) 931-60-57
P. A. Yartsev
N.V. Sklifosovsky Research Institute of Emergency Care of the Department of Health of the City of Moscow ; Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
Petr A. Yartsev
AuthorID: 694865, Researcher ID: P-9151-2017, Scopus Author ID: 55970485700
B. Sukharevskaya sq., 3, Moscow, 129090
Barrikadnaya st., 2/1, Moscow, 125993
D. A. Blagovestnov
N.V. Sklifosovsky Research Institute of Emergency Care of the Department of Health of the City of Moscow ; Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
Dmitry A. Blagovestnov
AuthorID: 553805, Scopus Author ID: 6506459353
B. Sukharevskaya sq., 3, Moscow, 129090
Barrikadnaya st., 2/1, Moscow, 125993
N. V. Karulin
N.V. Sklifosovsky Research Institute of Emergency Care of the Department of Health of the City of Moscow
Russian Federation
Russian Federation
Nikolai V. Karulin
Researcher ID:MBH-0067–2025
B. Sukharevskaya sq., 3, Moscow, 129090
References
1. Clinical recommendations of the Ministry of Health of the Russian Federation. Endometriosis. ICD-10: N80. ID: KP259/1. Russian Society of Obstetricians and Gynecologists. 2020. (In Russ.).
2. Parazzini F, Esposito G, Tozzi L, et al. Epidemiology of endometriosis and its comorbidities. Eur J Obstet Gynecol Reprod Biol. 2017;209:3–7. doi: 10.1016/j.ejogrb.2016.04.021
3. Ota Y, Andou M, Ota I. Laparoscopic surgery with urinary tractreconstruction and bowel endometriosis resection for deep infiltrating endometriosis. Asian J Endosc Surg. 2018;11(1):7–14. doi: 10.1111/ases.12464
4. Yong PJ, Bedaiwy MA, Alotaibi F, et al. Pathogenesis of bowel endometriosis. Best Pract Res Clin Obstet Gynaecol. 2021;71:2–13. doi: 10.1016/j.bpobgyn.2020.05.009
5. Chapron C, Marcellin L, Borghese B, et al. Rethinking mechanisms, diagnosis and management of endometriosis. Nat Rev Endocrinol. 2019 Nov;15(11):666–682. doi: 10.1038/s41574-019-0245-z Epub 2019 Sep 5. PMID: 31488888.
6. Wolthuis AM, Meuleman C, Tomassetti C, et al. Bowel endometriosis: colorectal surgeon’s perspective in a multidisciplinary surgical team. World J Gastroenterol. 2014;20(42):15616–15623. doi: 10.3748/wjg.v20.i42.15616
7. Bendifallah S, Puchar A, Vesale E, et al. Surgical Outcomes after Colorectal Surgery for Endometriosis: A Systematic Review and Meta-analysis. J Minim Invasive Gynecol. 2021;28(3):453–466. doi: 10.1016/j.jmig.2020.08.015
8. Donnez O, Roman H. Choosing the right surgical technique for deep endometriosis: shaving, disc excision, or bowel resection? Fertil Steril. 2017;108(6):931–942. doi: 10.1016/j.fertnstert.2017.09.006
9. Gallyamov EA, Aminova LN, Unanyan AL, et al. Review of literature about deep infiltrative endometriosis of rectovaginal division with. Modern Science: Current Problems of Theory and Practice. 2019;7:180–190. (In Russ.).
10. Goncharov A.L., Chicherina M.A., Chernyshenko T.A., et al. Features of colorectal resections in deep infiltrative endometriosis. Surgery. The N.I. Pirogov J. 2022;12(2):54–58. (In Russ.).
11. Report of the Chief Surgeon of the Russian Federation A. Reviashvili for 2023: «Surgical care in the Russian Federation in 2023». (in Russ.). https://online.anyflip.com/nvzse/ojni/mobile/index.html
12. Diebel LN, Dulchavsky SA, Wilson RF. Effect of increased intraabdominal pressure on mesenteric arterial and intestinal mucosal blood flow. J Trauma. 1992;68(1):45–49.
13. Matsuzaki S, Jardon K, Maleysson E, et al. Impact of intraperitoneal pressure of a CO2 pneumoperitoneum on the surgical peritoneal environment. Hum Reprod. 2012;27:1613–1623.
14. Collett D, Vitale GC, Reynolds M, et al. Peritoneal host defenses are less impaired by laparoscopy than by open operation. Surg Endosc. 1995;9:1059–1064
15. Champault G, Guillon P, Cruaud P. Taffinder Modifications of bacteria vitality due to CO2 used during endoscopic surgery. Surg Endos. 1994;8:971.
16. Wang G, et al. Effects of carbon dioxide pneumoperitoneum on the inflammatory response and bacterial translocation in intraabdominal infection. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2014;24(3):199–204.
17. Jacobi CA, et al. The impact of conventional and laparoscopic colon resection (CO2 or helium) on intraperitoneal adhesion formation in a rat peritonitis model. Surgical Endoscopy. 2001;15(4):380– 386.
18. Hanly EJ, et al. Abdominal insufflation with CO2 causes peritoneal acidosis independent of systemic pH. Journal Gastrointestinal Surgery. 2005;9(9):1245–1252.
19. Montalto AS, et al. CO2 pneumoperitoneum impact on early liver and lung cytokine expression in a rat model of abdominal sepsis. Surgical Endoscopy. 2012;26(4):984–989.
20. Holthausen UH, Nagelschmidt M, Troidl H. CO2 pneumoperitoneum: What we know and what we need to know. World Journal of Surgery. 1999;23(8):794–800.
21. Palombo JD, et al. Effects of laparoscopic vs laparotomy treatment of E. coli peritonitis on hemodynamic responses in a porcine model. Surgical Endoscopy. 1999;13(10):1001–1006.
22. Bachman SL, et al. The effect of timing of pneumoperitoneum on the inflammatory response. Surgical Endoscopy. 2004;18(11):1640– 1644.
23. Uematsu D, et al. Laparoscopic Hartmann’s procedure for fecal peritonitis resulting from perforation of the left-sided colon in elderly and severely ill patients. Tech. Coloproctol. 2012;16(3):243– 246.
24. Cuccurullo D, et al. Relaparoscopy for management of postoperative complications following colorectal surgery: ten years experience in a single center. Surgical Endoscopy. 2015;29(7):1795–1803.
25. Sukovatykh B.S., Blinkov Yu.Y., Ivanov P.A. Indications, contraindications and technology of video endoscopic abdominal rehabilitation in patients with widespread purulent peritonitis. Endoscopic surgery. 2018;5:3–8. (in Russ.).
26. Peng H, Zhang J, Cai C, et al. The Influence of Carbon Dioxide Pneumoperitoneum on Systemic Inflammatory Response Syndrome and Bacterial Translocation in Patients with Bacterial Peritonitis Caused by Acute Appendicitis. Surg Innovat. 2018;25(1):7–15.
27. Metzelder M, Kuebler JF, Shimotakahara A, et al. CO2 pneumoperitoneum increases survival in mice with polymicrobial peritonitis. Eur J Pediatr Surg. 2008;18:171–175.
28. Chatzimavroudis G, Pavlidis TE, Koutelidakis I, et al. CO2 pneumoperitoneum prolongs survival in an animal model of peritonitis compared to laparotomy. J Surg Res. 2009;152:69–75.
29. de Oliveira Machado SL, Bagatini MD, da Costa P, et al. Evaluation of mediators of oxidative stress and inflammation in patients with acute appendicitis. Biomarkers. 2016;21:530–537.
30. Shapovalyants S.G., et al. The use of video laparoscopic interventions in the treatment of patients with advanced peritonitis (methods and results). Endoscopic surgery. 2013;19(2):3– 41. (in Russ.).
31. Larichev A.B., Pokrovsky E.J. Videolaparoscopic technologies in the staged rehabilitation of the abdominal cavity in patients with widespread purulent peritonitis. Surgery. The N.I. Pirogov Journal. 2015;2:44–49. (in Russ.).
32. Ivakhov G.B. Modern approaches to surgical treatment of common peritonitis. Dissertation for the degree of Doctor of Medical Sciences, 2021. (in Russ.).
33. Francis NK, et al. EAES and SAGES 2018 consensus conference on acute diverticulitis management: evidence-based recommendations for clinical practice. Surgical Endoscopy. 2019;33(9):2726–2741.
34. Di Saverio S, Birindelli A, Mandrioli M, et al. Intracorporeal anastomoses in emergency laparoscopic colorectal surgery from a series of 59 cases: where and how to do it — a technical note. Colorectal Dis. 2017 Apr;19(4):O103-O107. doi: 10.1111/codi.13642
Review
For citations:
Arutyunyan A.S., Yartsev P.A., Blagovestnov D.A., Karulin N.V. Treatment of colon perforations after laparoscopic shaving of endometrioid foci of the colon (case report). Koloproktologia. 2025;24(1):62-71. https://doi.org/10.33878/2073-7556-2025-24-1-62-71
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