Novosti
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This journal is indexed in Scopus |
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Year 2013 Vol. 21 No 1
GENERAL AND SPECIAL SURGERY
B.N. ZHUKOV, V.R. ISAEV, A.V. ZHURAVLEV, A.A. CHERNOV, S.E. KATORKIN
EXPERIENCE OF CIRCULAR RESECTION OF THE MUCO- SUBMUCOSAL LAYER OF THE RECTAL LOWER AMPULLAR SECTION IN TREATMENT OF PATIENTS WITH RECTOCELE IN COMBINATION WITH CHRONIC INTERNAL HEMORRHOIDS OF 3-4 STAGE
SBEE HPE “Samara State Medical University”,
The Russian Federation
Objectives. To evaluate the treatment results of patients suffering from rectocele in combination with the chronic internal hemorrhoids after the circular endorectal resection of the muco-submucosal layer of the distal colon section.
Methods. The analysis of the surgical treatment results of 358 patients suffering from the chronic rectocele and chronic internal hemorrhoids who underwent the circular endorectal resection of the muco-submucosal layer of the distal colon section by A. Longo method was conducted. 3 subgroups of patients were formed: I – patients with rectocele in combination with the chronic internal hemorrhoids; II – females with rectocele without the chronic hemorrhoids; III – patients of both sexes suffering from the chronic internal hemorrhoids.
Rectoromanoscopy, sphincterometry, profilometry, irrigoscopy with defecography, transrectal and transvaginal ultrasound examination were applied. Standard surgical sets were used while carrying out the operations.
During early postoperative period dynamics and intensity of the pain syndrome were evaluated, complications were analyzed. Long-term treatment results were studied in 252 patients (70,4%). The number of recurrences was analyzed and defecography was performed.
Results. Postoperative complications (hemorrhage, urinary retention, external hemorrhoids nodules edema) developed in 37 patients (7,5%). Long-term analysis revealed the A. Longo method of operation in case of combination of rectocele and the chronic internal hemorrhoids permitted to achieve good and satisfactory results in 98,8% of patients.
Conclusions. The advantages of the circular resection method of the colonic submucosal layer in case of combination of rectocele and the chronic internal hemorrhoids are the followings: low incidence of trauma, the lack of significant pain syndrome in the postoperative period, shortening of hospitalization period as well as of medical and social rehabilitation terms. The method permits to eliminate the redundant mucosal prolapse, to remove rectocele and at the same time to make a strong connective muscular frame along the colon anterior wall.
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443079, Rossiiskaia Federatsiia, g. Samara, pr. Karla Marksa, d. 165 «b», Kliniki Samarskogo gosudarstvennogo meditsinskogo universiteta, kafedra i klinika gospital'noi khirurgii,
e-mail: katorkinse@mail.ru,
Katorkin Sergei Evgen'evich
Zhukov B.N. Honored Worker of science of RF, MD, professor, head of the chair and clinic of the hospital surgery of SBEE HPE “Samara State Medical University”.
Isaev V.R. MD, professor of the chair and clinic of the hospital surgery of SBEE HPE “Samara State Medical University”, chief freelance coloproctologist of MHC of Samara region.
Zhuravlev A.V. PhD, assistant of the chair and clinic of the hospital surgery of SBEE HPE “Samara State Medical University”.
Chernov A.A. PhD, head of the coloproctology department of the hospital surgery clinic of SBEE HPE “Samara State Medical University”.
Katorkin S.E. PhD, associate professor of the chair and clinic of the hospital surgery of SBEE HPE “Samara State Medical University”.
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