Aim: to identify risk factors for neoplasms recurrence removed by endoscopic mucosal resection (EMR).

Patients and methods: the single-center retrospective observational study included 207 patients with 260 benign colon neoplasms. There were 95 (45.9%) males and 112 (54.1%) females. The median age of the patients was 67 (27-80) years. The results obtained were assessed using following criteria: morbidity rate, complication type, hospital stay, tumor site, number of neoplasms in colon, lateral growth, fragmentation rate, technical difficulties (mucosal fold convergence)during surgery, grade of dysplasia, recurrence rate.

Results: intraoperative fragmentation of the neoplasms during mucosectomy occurred in 48/260 (18.5%) cases. Postoperative complications within the period of up to 30 days occurred in 13/207 (6.3%) patients. The most frequent 9 (4.2%) postoperative complication arising after mucosectomy was post-polypectomy syndrome. Another 4 (2.0%) patients produced bleeding after the surgery, which required repeated endoscopic procedure. No mortality occurred. The tumor size exceeding 25 mm (Exp (B) = 0.179; 95% CI = 0.05-0.7; p = 0.014), severe dysplasia (Exp (B) = 0.113; 95% CI = 0.03-0.4; p = 0.001) and fold convergence (Exp (B) = 0.2; 95% CI = 0.07-0.7; p = 0.015) are independent risk factors for disease recurrence.

Conclusion: mucosectomy is indicated for colon adenomas if its size does not exceed 25 mm and can be removed en bloc.

Aim: to work out of a set of measures aimed for early detection of colorectal tumors and the choice of a method of endoscopic surgery.

Patients and methods: a multimodal approach was used, which included two successive stages: the stage of assessing the depth of invasion of malignant colorectal epithelial tumors (1) and the stage of endoscopic surgery. The study included 974 patients, aged 67 (43-81) years. The algorithm of the systemic automatic approach to differentiate the depth of invasion of superficial malignant colorectal tumors has been worked out based on analysis of color pictures of colonoscopy (Colonoscopy Video Analysis). The results of use of automatic system were compared with experts’ assessment.

Results: the application of the developed algorithm of the systemic automatic approach to differentiate the depth of invasion of malignant ENC has high detection accuracy – the total average detection accuracy when implementing this algorithm is 72.02. No significant differences with experts’ assessment were obtained. With endoscopic removal of malignant tumors with superficial invasion, the correct selection of patients based on the tumor size (up to 2.0 and over 2.0 cm) and the corresponding removal technique (mucosal resection or endoscopic submucosal dissection) are decisive.

Conclusion: the automatic system of evaluation of tumor invasion depth has a high accuracy and gives a possibility to exclude false positive results.

Aim: to evaluate the results of original manual intracorporeal end-to-end invagination ileotransverse anastomosis after laparoscopic right hemicolectomy.

Patients and methods: twenty-two patients with right colon cancer were included in the study: 17 females and 5 males aged 53.1±3.4 years. They underwent laparoscopic right hemicolectomy with the standard D2 lymphadenectomy and intracorporeal ileotransverse anastomosis by the original technique. Follow-up period after surgery was 3 months.

Results: no conversions to open surgery occurred. The operation time was 120.0±12.5 minutes, the median blood loss was 87.0±5.0 ml. Twenty (90.9%) patients are still under follow-up. The hospital stay was 11.4±2.6 days. There were no intraoperative complications. There were no cases of anastomotic leakage. No mortality occurred. At the time of the follow-up, all the patients are alive. Two (9.1%) patients have dropped out of control.

Conclusion: the experience of the first 22 laparoscopic right hemicolectomies with intracorporeal laparoscopic end-to-end invagination ileotransverse anastomosis makes it possible to recommend this reliably safe method.

Aim: to assess the efficacy of intranodal laser coagulation for hemorrhoids stage III.

Patients and methods: the study included 62 patients with chronic internal hemorrhoids stage III without external hemorrhoids, who were informed of the INLC technology, its advantages and disadvantages. The selection for this procedure was done due to the high-resolution anoscopy, in the presence of type 1 and type 2 severity of inflammatory changes in the nodes.

Results: on the 3rd day, no pain occurred in 52 (83.9%) patients. After 12 months, a complete disappearance of hemorrhoid symptoms was observed in 51 (82.3%) patients, while 7 (11.3%) patients had a recurrence. In 8 (12.9%) patients, symptoms of discomfort and itching were noted.

Conclusions: intranodal laser coagulation allowed in 61 (98.4%) cases to perform this procedure on an outpatient basis, and did not affect the anal sphincter function. Good long-term results were obtained in 82.3% of cases. Intranodal laser coagulation is an effective method for chronic hemorrhoids.

Endoscopic removal of giant adenomas of the cecum is associated with high risk of perforation and conversion to laparoscopic procedure. Endoscopic submucosal dissection for cecal adenomas had technical limitations due to the adjacent ileocecal valve and appendix opening, perpendicular operating angle. Case presentation of the possibility of successful removal of a large laterally spreading cecal adenoma by the method of endoscopic submucosal tunnel dissection (ESTD) never been described before for this tumor site and size. Patient 54 years old, an LST-G adenoma (5 cm in diameter, according to Kudo – IIIL, according to Sano – II) was detected in the dome of the cecum during colonoscopy. ESTD. The postoperative period without any unfavorable events; the patient was discharged on the 5th day after surgery. The morphological conclusion: tubulo-villous adenoma with moderate epithelial dysplasia, R0. ESTD is suitable for cecal giant adenomas.

Extragenital endometriosis is one of the most severe benign diseases of the female reproductive system, characterized by different site of target organs. This pathology is associated with the development of severe complications, the treatment of which requires a multidisciplinary approach. This case report is dedicated to the experience of treating a patient with a history of multiple surgical procedures and long-term undiagnosed deep infiltrative endometriosis, complicated by abdominocutaneus endometriotic fistula.

The COVID-19 pandemic, with it is rapid increase in new cases and deaths, has caused hospital overload around the world, creating an unprecedented challenge for health systems and requiring the rapid development of reliable and evidence-based guidelines. Moreover, this has led to urgent identification of non-COVID health priorities. The cancer service must be restructured. Diagnosis and treatment for colorectal cancer in the background of the COVID-19 pandemic requires a restrained approach based on the priority of patient care.

Aim: search for modifiable and unmodifiable risk factors affecting the quality of life of patients after rectal cancer surgery.

Materials and methods: the literature search was done according to the keywords: quality of life, rectal cancer, low anterior resection syndrome. Twelve prospective randomized studies, 2 cohort studies, and 2 meta-analyses are included in the study. The quality of life was assessed in the analyzed studies by using questionnaires for cancer patients and updated questionnaires for colorectal cancer: EORTC QLQ-CR29, QLQ-C30, QLQ-CR38, BIQ.

Results: the literary data on influence of gender, age, surgery, stoma, and chemoradiotherapy on life quality of patients after rectal cancer surgery was analyzed.

Conclusion: the most significant factor affecting the life quality of patients with rectal cancer is a violation of the body image if it is necessary to form the stoma on the anterior abdominal wall. The manifestations of the low anterior resection syndrome and the urination problems are significant risk factors in the case of restoration of bowel continuity.

The aim of the review is to show possible links between intestinal microbiota and colorectal carcinogenesis, to describe the procarcinogenic properties of microorganisms associated with the development or proliferation of colorectal cancer. The gut microbiota plays a leading role in metabolism, providing important metabolites to the macroorganism. In humans, there is a spatial variability in the qualitative and quantitative microbiota composition. The intestinal microbiota provides the colony resistance, protecting it from colonization by opportunistic and pathogenic microorganisms. There is more and more data on the role of the gut microbiota in the development of colorectal cancer. The profound study of the gut microbiome in various populations is required, which will allow to identify other microorganisms associated with the development or proliferation of colorectal cancer. It can be used as biomarkers for colorectal cancer screening and predicting the response to immunotherapy.

The aim of the review was to describe the evolution of scientific ideas about the syndrome of pseudo-obstruction of the large intestine (Ogilvie syndrome), taking into account the etiopathogenesis, clinical manifestations, the incidence of the disease, the state-of-art in diagnosis and treatment. The paper presents an analysis of the literature on the pseudoobstruction of the colon (Ogilvie syndrome) – the acute dilatation of the colon in the absence of any mechanical obstruction. The essence of the concept, the correctness of the notation, definitive criteria, terminology, pathophysiological and pathogenetic aspects of the disease according to the literature are described. The diagnostic and treatment algorithms are correctly described with an assessment of their effectiveness in accordance with the principles of evidence-based medicine. Despite the large number of publications devoted to Ogilvie syndrome and the increased awareness of doctors of various specialties on this pathology, its diagnostics is still difficult and often untimely.

Hemorrhoidectomy is considered as the “gold standard” for hemorrhoidal disease, but is associated with a long rehabilitation period. For this reason, 20 years ago, an innovative method for hemorrhoids was developed – Doppler-guided hemorrhoidal dearterialization. The aim of the work is to analyze the literary data of the use of Doppler-guided dearterialization for hemorrhoidal disease, the technical evolution of the method and the analysis of the results. An analysis of the literature shows that Dopplerguided dearterialization is a safe and effective method for hemorrhoidal disease. The combination of dearterialization with transanal mucopexy improves outcomes in patients with hemorrhoids III and IV stages. However, good results can be obtained not in all forms of hemorrhoidal disease. The efficacy depends on the peculiar features of the anorectal zone vascularization, the degree of destruction of the suspensory ligaments of the internal hemorrhoidal plexus and the degree of enlargement of the external hemorrhoid plexus. The adequacy of the dearterialization and mucopexy requires an objective control for assessment of the procedure.