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    1. State scientific centre of coloproctology (Moscow, Russian Federation)

    Keywords:idiopathic megacolon,idiopathic megarectum,longitudinal proctoplasty

    Abstract:The study focuses on surgical treatment of idiopathic megacolon and megarectum. Methods: 36 patients (18-78 years, 20 male) were operated in 2004-2014. 25 (69.4 %) patients had idiopathic megacolon. 11 (30.6 %) patients had idiopathic megarectum with or without megacolon. The choice of surgical procedure depended on extent and localization of megacolon and function of nondilated colon. Left colectomy was performed in 12 (33.3 %) cases, subtotal colectomy and ascendorectal anastomosis - in 13 (36.1 %) cases. All patients with idiopathic megarectum were undergone longitudinal proctoplasty combined with left colectomy or subtotal colectomy. Results: After surgery 1 (2.8 %) patient died and 5 (13.9 %) had complications that required reoperation. In follow up 1 patient have got megacolon recurrence. 9 of idiopathic megarectum patients whom stoma was closed were followed up. There were not megacolon or megarectum recurrence. In 8 (88.9 %) patients were detected significant improvement and satisfaction with surgery. There also was found significant reduction of constipation rate and rectal function improvement. No one patient had sexual or urological impairment. Conclusion: In cases of idiopathic megacolon only dilated colon resection may be justified in selected patients with good function of nondilated colon. Longitudinal proctoplasty leads to significant improvement of rectal function and may be used in idiopathic megarectum surgical treatment.%

      1. Ачкасов С. И., Алешин Д. В. Способ хирургического лечения идиопатического мегаректум. Патент № 2516118 Приоритет изобретения 20.12.2012.
      2. Воробьев Г.И., Жученко А. П., Ачкасов С. И., Капуллер Л. Л., Бирюков О. М. Возможности модификации биопсии стенки прямой кишки по Свенсону в диагностике пороков развития интрамуральной нервной системы у взрослых. Хирургия, 2005, № 10, с. 4-7.
      3. Воробьев Г. И. Мегаколон у взрослых (клиника, диагностика и хирургическое лечение). Диссертация докт. мед наук. Москва, 1982. 402 с.
      4. Ding W1, Jiang J, Feng X, Yao A, Liu J, Li N, Li J. Outcomes after surgery for refractory constipation patients complicated with megacolon. Zhonghua Wei Chang Wai Ke Za Zhi. 2014 May;17(5):453-6.
      5. Gattuso J.M., Kamm M. A., Talbot I. C. Pathology of idiopathic megarectum and megacolon. Gut 1997; 41: 252-257.
      6. Gattuso JM, Kamm MA. Clinical features of idiopathic megarectum and idiopathic megacolon. Gut. 1997;41:93
      7. Gladman MA, Scott SM, Lunniss PJ, Williams NS. Systematic review of surgical options for idiopathic megarectum and megacolon. Ann Surg 2005; 241: 562-74
      8. Gladman MA, Lunniss PJ, Williams NS, Scott SM. Rectal hyposensitivity: pathophysiological mechanisms. Neurogastroenterol Motil 2005; 17(Suppl. 2): 18.
      9. Huang ZC 1, Liu Q, Li SG, Li D, Su J, Yan DY, Xiao ZG, Dong HY, Zhou K. Diagnosis and treatment of slow transit constipation complicated with adult megacolon. Zhonghua Wei Chang Wai Ke Za Zhi. 2011 Dec;14(12):941-3.
      10. Waldron D, Bowes KL, Kingma YJ, Cote KR. Colonic and anorectal motility in young women with severe idiopathic constipation. Gastroenterology 1988; 95: 1388-1394.
      11. Williams NS, Fajobi OA, Lunniss PJ, Scott SM, Eccersley AJP, Ogunbiyi OA. Vertical reduction rectoplasty: a new treatment for idiopathic megarectum. Br J Surg 2000; 87: 1203-1208.
      12. Varma JS, Smith AN. Neurophysiological dysfunction in young women with intractable constipation. Gut 1988; 29: 963-968.

    Full text is published :
    Aleshin O.V., Achkasov S.I., Fomenko O.Yu. SURGICAL TREATMENT OF IDIOPATHIC MEGACOLON AND MEGARECTUM. Experimental and Clinical Gastroenterology Journal. 2017;139(03):56-59
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    1. RUDN University (Moscow, Russian Federation)

    Keywords:colorectal cancer,colonic obstruction,stenting

    Abstract:Colorectal cancer is one of the common forms of malignancies in the world. Despite advances in the diagnosis of early stage of the disease in a large enough number of patients develop clinical bowel obstruction. Colorectal stenting is a minimally invasive alternative to emergency surgery, associated with high morbidity and mortality. Since its first application in 1991, has accumulated a lot of experience not only as palliative care for inoperable patients, but also as a «bridge to surgery» for radical treatment. In this review, the literature data relating to various techniques, indications and contraindications, results and complications of stenting in colonic obstruction.

      1. Alcantara M., Serra-Aracil X., Falco J. et al. Prospective, controlled, randomized study of intraoperative colonic lavage versus stent placement in obstructive left-sided colonic cancer.World J Surg, 2011, Vol.35, pp.1904-10.
      2. Baron T. Technique of colonic stenting. Techniques in Gastrointestinal Endoscopy, 2014, Vol.16, рр.108-111.
      3. Cennamo V., Luigiano C., Coccolini F., et al. Meta-analysis of randomized trials comparing endoscopic stenting and surgical decompression for colorectal cancer obstruction. Int J Colorectal Dis, 2013, Vol.28, pp.855-863.
      4. Chang IS., Park SW., Hwang D-Y. The Eficacy of the Coaxial Technique Using a 6-Fr Introducer Sheath in Stent Placement for Treating the Obstructions Proximal to the Descending Colon. Korean J Radiol, 2011, Vol.12, рр.107-112.
      5. Cheung DY., Lee YK., Yang CH. Status and Literature Review of Self-Expandable Metallic Stents for Malignant Colorectal Obstruction. Clinical Endoscopy,2014, Vol. 47, рр. 65-73.
      6. Cirocchi R., Farinella E., Trastulli S., et al. Safety and efficacy of endoscopic colonic stenting as a bridge to surgery in the management of intestinal obstruction due to left colon and rectal cancer: a systematic review and meta-analysis. Surg Oncol, 2013, Vol.22, pp. 14-21.
      7. De Ceglie A., Filiberti R., Baron TH., et al. A metaanalysis of endoscopic stenting as bridge to surgery versus emergency surgery for left-sided colorectal cancer obstruction. Crit Rev Oncol Hematol, 2013, Vol.88, pp.387-403.
      8. Dohmoto M., Rupp KD., Hohlbach G. Endoscopically-implanted prosthesis in rectal carcinoma. Dtsch Med Wochenschr 1990, Vol.115, рр.915.
      9. Fiori E., Lamazza A., Schillaci A., et al. Palliative management for patients with subacute obstruction and stage IV unresect-able rectosigmoid cancer: colostomy versus endoscopic stenting: final results of a prospective randomized trial. Am J Surg, 2012, Vol.204, pp.321-326.
      10. Govindarajan А., Naimark D., Coburn NG. Use of Colonic Stents in Emergent Malignant Left Colonic Obstruction: A Markov Chain Monte Carlo Decision Analysis. Dis Colon Rectum, 2007, Vol. 50, N. 11, pp.1811-24.
      11. Ho KS., Quah HM., Lim JF., et al. Endoscopic stenting and elective surgery versus emergency surgery for left-sided malignant colonic obstruction: a prospective randomized trial. Int J Colorectal Dis, 2012, Vol.27, pp.355-362.
      12. Huang X., Lv B., Zhang S., Meng L. Preoperative colonic stents versus emergency surgery for acute left-sided malignant colonic obstruction: a meta-analysis. J Gastrointest Surg, 2014, Vol.18, pp.584-591.
      13. Jeong JB., Lee KL., Kwon SB., et al. Palliative self-expanding metal stents in the treatment of malignant colorectal obstruction. Intest Res, 2010, Vol.8, рр.135-141.
      14. Kobayashi Y., Komazawa Y., Kusunoki M. Novel stenting method for malignant right colonic stenosis using ultra-thin endoscopy: Repor t of four cases. Digestive Endoscopy, 2015 Vol.27, рр.704-707
      15. Lee HJ., Park SJ., Cheon JH. What is the necessity of endoscopist for successful endoscopic stenting in patients with malignant colorectal obstruction? Int J Colorectal Dis. 2015, Vol.30, pp.119-125.
      16. Lee J., Byeon J. Colorectal Stents: Current Status. Clinical Endoscopy,2015, Vol. 48, рр.194-200.
      17. Lee KJ., Kim SW., KimTI., et al. Evidence-Based Recommendations on Colorectal Stenting: A Report from the Stent Study Group of the Korean Society of Gastrointestinal Endoscopy. Clinical Endoscopy, 2013, Vol.46, pp.355-367.
      18. Liang TW., Sun Y., Wei YC., et al. Palliative treatment of malignant colorectal obstruction caused by advanced malignancy: a self-expanding metallic stent or surgery? A system review and meta-analysis. Surg Today, 2014, Vol.44, pp. 22-33.
      19. Meisner S. Stent for palliation of advanced colorectal cancer. Techniques in Gastrointestinal Endoscopy, 2014, Vol.16, рр. 125-128.
      20. Park S., Cheon JH., Park JJ., Moon CM., Hong SP., Lee SK. Comparison of efficacies between stents for malignant colorectal obstruction: a randomized, prospective study. Gastrointest Endosc, 2010, Vol.72, рр. 304-10.
      21. Sagar J. Colorectal stents for the management of malignant colonic obstructions. Cochrane Database Syst Rev, 2011, Vol.11, CD 007378
      22. Sagar J. Role of colonic stents in the management of colorectal cancers. World J Gastrointest Endosc, 2016, Vol.8, N.4, pp.198-204.
      23. Sebastian S., Johnston S., Geoghegan T., et al. Pooled analysis of the efficacy and safety of self-expanding metal stenting in malignant colorectal obstruction. Am J Gastroenterol, 2004, Vol.99, pp.2051-2057.
      24. Shimura T., Joh T. Evidence-based Clinical Management of Acute Malignant Colorectal Obstruction. J Clin Gastroenterol Volume 50, Number 4, April 2016.
      25. Sloothaak D., van den Berg MM., Dijkgraaf M. Oncological outcome of malignant colonic obstruction in the Dutch Stent-In 2 trial. Br J Surg, 2014, Vol.101, pp. 1751-7.
      26. Song HY., Kim JH., Shin JH., et al. A dual-design expandable colorectal stent for malignant colorectal obstruction: results of a multicenter study. Endoscopy 2007, Vol.39, рр. 448-54.
      27. Song H-Y., Nam DH., Lee H. Usefulness of a Guiding Sheath for Fluoroscopic Colorectal Stent Placement. Korean J Radiol, 2012, Vol.13, Supp.1, S 83-88.
      28. Srinivasan N., Kozarek R. Stents for colonic strictures: Materials, designs, and more. Techniques in Gastrointestinal Endoscopy, 2014, Vol.16, рр.100-107.
      29. Tack J., Gevers AM., Rutgeerts P. Self-expandable metallic stents in the palliation of rectosigmoidal carcinoma: a follow-up study. Gastrointestinal Endoscopy 1998, Vol.48, рр.267-71.
      30. Tan CJ., Dasari BV., Gardiner K. Systematic review and metaanalysis of randomized clinical trials of self-expanding metallic stents as a bridge to surgery versus emergency surgery for malignant left-sided large bowel obstruction. Br J Surg, 2012, Vol.99, pp.469-476.
      31. Tejero E., Mainar A., Fernández L., et al. New procedure for the treatment of colorectal neoplastic obstructions. Dis Colon Rectum 1994, Vol.37, рр.1158-9.
      32. The role of endoscopy in the management of patients with known and suspected colonic obstruction and pseudo-obstruction. Gastrointestinal Endoscopy, 2010, Vol. 71, N. 4, pp.669-79.
      33. Tung KL., Cheung HY., Ng LW., et al. Endolaparoscopic approach versus conventional open surgery in the treatment of obstructing left-sided colon cancer: long-term follow up of a randomized trial. Asian J Endosc Surg, 2013, Vol.6, pp.78-81.
      34. van Halsema EE., van Hooft JE. Outcome and complications of stenting for malignant obstruction Techniques in Gastrointestinal Endoscopy, 2014, Vol.16, pp.129-134.
      35. van Hooft JE, Bemelman WA, Oldenburg B, et al. Colonic stenting versus emergency surgery for acute left-sided malignant colonic obstruction: a multicentre randomized trial. Lancet Oncol, 2011, Vol.12, рр.344-352.
      36. van Hooft JE et al. Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy, 2014, Vol.46, рр.990-1002.
      37. van Hooft JE., Fockens P., Marinelli AW., et al. Early closure of a multicenter randomized clinical trial of endoscopic stenting versus surgery for stage IV left-sided colorectal cancer. Endoscopy, 2008, Vol.40, pp.184-191.
      38. van den Berg E., Bergmann J. F., Ledeboer M. Radiological Position and Clinical Outcome of Preoperative Self-Expanding Metal Stents for Obstructing Colonic Cancer: A Single-Centre Cohort Study. Dig Surg, 2015, Vol.32, рр.262-268.
      39. World Cancer Report 2014/ Edited by Sterwart B. W. and Wild C. P. Lyon, 2014. p.630
      40. Xinopoulos D., Dimitroulopoulos D., Theodosopoulos T., et al. Stenting or stoma creation for patients with inoperable malignant colonic obstructions? Results of a study and cost-effectiveness analysis. Surg Endosc. 2004, Vol.18, pp.421-426.
      41. Ye GY., Cui Z., Chen L., Zhong M. Colonic stenting vs emergent surgery for acute left-sided malignant colonic obstruction: a systematic review and meta-analysis. World J Gastroenterol, 2012, Vol.18, pp.5608-5615
      42. Yoon J., Kwon SH., Lee C-K. Radiologic Placement of Uncovered Stents for the Treatment of Malignant Colonic Obstruction Proximal to the Descending Colon. Cardiovasc Intervent Radiol
      43. Yoon JY., Jung YS., Hong SP., et al. Outcomes of secondary stent-in-stent self-expandable metal stent insertion for malignant colorectal obstruction. Gastrointest Endosc, 2011, Vol.74, рр.625-633.
      44. Yoon JY., Park SJ., Hong SP., et al. Outcomes of secondary self-expandable metal stents versus surgery after delayed ini-tial palliative stent failure in malignant colorectal obstruction. Digestion, 2013, Vol.88, рр.46-55.
      45. Young CJ., De-loyde KJ., Young JM., et al. Improving Quality of Life for People with Incurable Large-Bowel Obstruction: Randomized Control Trial of Colonic Stent Insertion. Dis Colon Rectum, 2015, Vol.58, pp.838-849.
      46. Zhang Y., Shi J., Shi B., et al. Self-expanding metallic stent as a bridge to surgery versus emergency surgery for obstructive colorectal cancer: a meta-analysis. Surg Endosc, 2012, Vol.26, pp.110-119.
      47. Zhao XD., Cai BB., Cao RS., et al. Palliative treatment for incurable malignant colorectal obstructions: a meta-analysis. World J Gastroenterol, 2013, Vol.19, pp. 5565-5574.

    Full text is published :
    Vodoleev A.S., Duvanskiy V.A. COLORECTAL STENTING FOR THE TREATMENT OF MALIGNANT COLONIC OBSTRUCTION. Experimental and Clinical Gastroenterology Journal. 2017;139(03):60-66
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