Submission of the manuscript is online via e-mail
ecgarticle@gmail.com or
cholerez@mail.ru

Tel: +7 903 250 5288

Editorial Correspondence e-mail
gastrossr@gmail.com


Publishing, Subscriptions, Sales and Advertising, Correspondence e-mail
journal@cniig.ru

Tel: +7 917 561 9505

SCImago Journal & Country Rank

    1. State Budgetary Institution of Health Care “Region Clinic Hospital Nr 2” Health Ministry of Krasnodar Region, 350112, Krasnodar, Russia
    2. Federal State Budgetary Educational Institution of Higher Education “Kuban State Medical University” Health Ministry of Russian Federation, 350112, Krasnodar, Russia

    Keywords: scarring stricture, bowel, hardware bougienage, balloon dilatation, colonoscopy

    Abstract:The aim of investigation: determination of the eff ectiveness of endoscopic methods in treatment of patients with low scarring strictures of bowel in settings of SBIHC “Region Clinic Hospital Nr 2” Materials and methods: we analyzed the treatment of 32 patients with low scarring strictures of bowel. The reasons of development of scarring narrowings and options of endoscopic treatment of this group of patients were studied. The causes of formation of scarring strictures in 29 patients (91,0%) were operarions performed. In 3 patients (9,0%) of this group low scarring strictures developed on the background of infl ammatory bowel disease performed. Results: in SBIHC “Region Clinic Hospital Nr 2” the following methods of endoscopic recanalization of scarring strictures were used: hardware bougienage were performed in 12 patients (37,5%), mechanical bougienage (using silicone bougies) in 6 patients (18,8%), combination of methods of hardware and mechanical bougienage was used in 4 patients (12,5%), balloon dilatation as the method of the extension of the lumen was used in 4 patients (12,5%), combination of methods of mechanical bougienage and balloon dilatation was used in 4 (12,5%) patients, stenting with nitinole self-expanding stents was used in 2 patients (6,2%). The effi ciency of used methods was 72%. In the majority of cases (65,6%) multi-stage treatment was required. In patients with whom we failed to achieve adequate expansion of the lumen the reconstructive surgery was performed. Conclusion: endoscopic methods of recanalization of the lumen in scarring narrowings are suffi ciently eff ective with compliance of conditions of dynamic observation.

      1. Veselov V. V., Achkasov S. I., Vaganov Y. E., Skridlevsky S. N., Merkulova E. S. et al. Endoscopic treatment of corrosive strictures of intestinal anastomosis. Scientifi c and practical medical journal of the all-Russian public organization “Association of coloproctologists of Russia”. 2015, vol. 89, no.01, pp. 21–26.
      2. Cady J. Strictures aft er stapled anastomosis incolo-rectal surgery. European congresson stapling in surgery. – 1991 – Р.127–131
      3. Kotelnikova L. P., Shatrova N. A., Belyakova Ya. V. Th e long-term results aft er left -sided colonic and rectal resections. «Modern problems of science and education» 2012, vol. 457, no.02, pp.78.
      4. Kuzmin-Krutetskiy M. I., Hanewich M. A. Endoscopichescoe lechenie striktur tolstokishechnih anastomozov [Endoscopic treatment of colonic anastomosis strictures]. Terra medica-1998, no.03, pp. 26–27
      5. A. I. Chernookov, M. M. Karapetyan, V. V. Bagdasarov, Е. А. Bagdasarova, M. V. Kosachenko, et al. Colorectal Stenting for Treatment of Malignant Large Bowel Obstruction. Novosti Khirurgii. 2016, Vol 24, no.05, pp. 497–507.
      6. Klimashevich A. V., Nikolski V. I., Bogonina O. V. et al. Profi laktika I lechenie rubzovih striktur pishevoda [Prevention and treatment of cicatricial esophageal strictures]. Fundamental study. 2012, no.04 (1), pp. 63–68.
     


    Full text is published :
    Gabriel S. A., Durleshter V. M., Guchetl A. Ya., Krushelnitskiy V. S., Dynko V. Yu., Tlekhuray R. M., Kortieva A. T., Ignatenko V. V. Endoscopic possibilities in of patients with low cicatricial strictures. Experimental and Clinical Gastroenterology. 2019;162(2): 84–88. (In Russ.) DOI: 10.31146/1682-8658-ecg-162-2-84-88
    Read & Download full text

    1. Moscow regional research and clinical Institute n. a. M. F. Vladimirsky, Moscow, Russia
    2. City clinical hospital № 24, Moscow, Russia

    Keywords: low- ampullar rectal cancer, magnetic resonance imaging, metastasis, lymph nodes

    Abstract:Rectal cancer is one of the leaders in the structure of mortality in both sexes, with the only radical method of treatment is surgery. For the planning of surgical treatment, it is important to assess the metastatic lesion of the locoregional lymph nodes, which is an important predictor of the recurrence of the disease. The effi ciency and accuracy of the preoperative determination of metastatic regional lymph nodes in low-ampullar rectal cancer increased signifi cantly after the introduction into clinical practice of magnetic resonance imaging with the use of diff usion-weighted image and a non-ionic paramagnetic. The article is devoted to the problems of preoperative staging and determination of metastases in regional pararectal lymph nodes by comparing the results of MRI studies with contrast enhancement and MRI with diff usion-weighted images (DWI) in the diagnosis of metastases –positive locoregional lymph nodes, comparison with the data of histological studies of intraoperative material.

      1. Kaprin A. D., Starinskij V. V., Petrova G. V. Sostoyanie onkologicheskoj pomoshchi naseleniyu Rossii v 2016 godu. Moscow, MNIOI im. P. A. Gercena-fi lial FGBU “NMIRC” Minzdrava Rossii, 2017.-ill.-236 s. ISBN978– 5–85502–231–5
      2. Al-Sukhni E, Milot L, Fruitman M, Beyene J, Victor JC, Schmocker S, Brown G, McLeod R, Kennedy E. Diagnostic accuracy of MRI for assessment of T category, lymph node metastases and circumferential resection margin involvement in patients with rectal cancer: A systematic review and meta-analysis. AnnSurgOncol. 2012;19:2212–2223. doi: 10.1245/s10434–011–2210–5.
      3. Brown G., Richardson C. J., Newcombe R. G. at al. //Radiology.-1999-Vol.211.-P.215–222.
      4. Brush J, Boyd K, Chappell F, Crawford F, Dozier M, Fenwick E, et al. Th e value of FDG positron emission tomography/computerised tomography (PET/CT) in pre-operative staging of colorectal cancer: a systematic review and economic evaluation. Health Technol Assess. 2011;15(35):1–192. doi: 10.3310/hta15350.
      5. Chmoll HJ, Van Cutsem E, Stein A, Valentini V, Glimelius B, Haustermans K, Nordlinger B, van de Velde CJ, Balmana J, Regula J, et al. ESMO consensus guidelines for management of patients with colon and rectal cancer. A personalized approach to clinical decision making. Ann Oncol. 2012;23:2479–2516. doi: 10.1093/annonc/mds236.
      6. unter C.J., Garant A., Vuong T., Artho G., Lisbona R., Tekkis P., et al. Adverse features on rectal MRI identify a high-risk group that may benefi t from more intensive preoperative staging and treatment. // Ann SurgOncol. 2012;19:1199e205. doi: 10.1245/s10434–011–2036–1.
      7. Kijima S, Sasaki T, Nagata K, Utano K, Lefor AT, Sugimoto H. Preoperative evaluation of colorectal cancer using CT colonography, MRI, and PET/CT. World J Gastroenterol. 2014;20(45):16964–16975. doi: 10.3748/wjg.v20. i45.16964
      8. Klessen C, Rogalla P, Taupitz M. Local staging of rectal cancer: Th e current role of MRI. EurRadiol. 2007;17:379– 389. doi: 10.1007/s00330–006–0388-x.
      9. KohD.M., A. Dzik-Jurasz, B. O’Neill Pelvic phased-array MR imaging of anal carcinoma before and aft er chemoradiation. // Br. J. Radiol. – 2008. – Vol.81, No962. – P. 91–98.
      10. Koh D., Blackledge M., Padhani A. R., Takahara T., Kwee T. C., Leach M. O. Whole-Body Diff usion-weighted MRI: Tips, tricks, and pitfalls. // Am. J. Roentgenol. 2012;199:252–262. doi: 10.2214/AJR.11.7866.
      11. Koh DM, George C, Temple L, Collins DJ, Toomey P, Raja A, Bett N, Farhat S, Husband JE, Brown G. Diagnostic accuracy of nodal enhancement pattern of rectal cancer at MRI enhanced with ultrasmall superparamagnetic iron oxide: fi ndings in pathologically matched mesorectal lymph nodes. // AJR Am J Roentgenol. 2010 Jun;194(6): W505–13. doi: 10.2214/AJR.08.1819.
      12. Lambrecht M., et al. Value of diff usion-weighted magnetic resonance imaging for prediction and early assessment of response to neoadjuvant radiochemotherapy in rectal cancer: preliminary results. // Int J RadiatOncolBiol Phys. 2012;82(2):863–70. doi: 10.1016/j.ijrobp.2010.12.063.
      13. Lambregts D., Vandecaveye V., Barbaro B., Bakers F. C.H., Lambrecht M., Maas M. Diff usion-weighted MRI for selection of complete responders aft er chemoradiation for locally advanced rectal cancer: A multicenter study. // Ann. Surg. Oncol. 2011;18:2224–2231. doi: 10.1245/ s10434–011–1607–5
      14. Lambregts D.M., Cappendijk V. C., Maas M., Beets G. L., Beets-Tan R. G. Value of MRI and diff usion-weighted MRI for the diagnosis of locally recurrent rectal cancer. // EurRadiol. 2011;21:1250–8. doi: 10.1007/s00330–010– 2052–8.
      15. Lambregts D.M., et al. Diff usion-weighted MRI for selection of complete responders aft er chemoradiation for locally advanced rectal cancer: a multicenter study. // Ann SurgOncol. 2011;18(8):2224–31. doi: 10.1245/ s10434–011–1607–5.
      16. Martin S.T., Heneghan H. M., Winter D. C. Systematic review of outcomes aft er intersphincteric resection for low rectal cancer. // Br. J. Surg. 2012; 99: 603–12.
      17. Matsuoka H., Nakamura A., Masaki T., Sugiyama M., Takahara T., Hachiya J., Atomi Y. Comparison between endorectal coil and pelvic phased-array coil magnetic resonance imaging in patients with anorectal tumor. // Am J Surg. 2003;185(4):328–332.
      18. McCarthy K., Pearson K., Fulton R., et al. Pre-operative chemoradiation for non-metastatic locally advanced rectal cancer. // Cochrane Database Syst Rev 2012; 12: CD008368.
      19. McMahon C.J., Rofsky N. M., Pedrosa I. Lymphatic metastases from pelvic tumors: anatomic classifi cation, characterization and staging. // Radiology. 2010. Vol. 254. P. 31–46.
      20. Mizukami Y, Ueda S, Mizumoto A, Sasada T, Okumura R, Kohno S, Takabayashi A. Diff usion-weighted magnetic resonance imaging for detecting lymph node metastasis of rectal cancer. World J Surg. 2011;35:895–899. doi: 10.1007/s00268–011–0986-x.
      21. Mizukami Y., Ueda S., Mizumoto A., Sasada T., Okumura R., Kohno S., et al. Diff usion-weighted magnetic resonance imaging for detecting lymph node metastasis of rectal cancer. // World J Surg. 2011;35:895–899
      22. Quadros C.A., Falcão M. F., Carvalho M. E., Ladeia P. A., Lopes A. Metastases to retroperitoneal or lateral pelvic lymph nodes indicated unfavorable survival and high pelvic recurrence rates in a cohort of 102 patients with low rectal adenocarcinoma. // J SurgOncol. 2012;106:653–658. doi: 10.1002/jso.23144.
      23. Rahmim A, Qi J, Sossi V. Resolution modeling in PET imaging: theory, practice, benefi ts, and pitfalls. Med Phys. 2013;40(6):064301. doi: 10.1118/1.4800806
      24. Seber T., Caglar E., Uylar T., Karaman N., Aktas E., Aribas B. K. Diagnostic value of diff usion-weighted magnetic resonance imaging: diff erentiation of benign and malignant lymph nodes in diff erent regions of the body. // Clin Imaging. 2015;39(5):856–862.
      25. Soret M, Bacharach SL, Buvat I. Partial-volume eff ect in PET tumor imaging. J Nucl Med. 2007;48(6):932–945. doi: 10.2967/jnumed.106.035774. [PubMed] [CrossRef]
      26. Torkzad MR, Påhlman L, Glimelius B. Magnetic resonance imaging (MRI) in rectal cancer: A comprehensive review. InsightsImaging. 2010;1:245–267. doi: 10.1007/ s13244–010–0037–4.
      27. Tsunoda Y, Ito M, Fujii H, Kuwano H, Saito N. Preoperative diagnosis of lymph node metastases of colorectal cancer by FDG-PET/CT. Jpn J ClinOncol. 2008;38(5):347–353. doi: 10.1093/jjco/hyn032.
     


    Full text is published :
    Volkova S. N., Stashuk G. A., Vishnyakova M. V., Chermensky G. V., Levchenko S. V. Capabilities of magnetic resonance imaging in evaluating metastatic regional lymph nodes in lower ampullar rectal cancer. Experimental and Clinical Gastroenterology. 2019;162(2): 89–95. (In Russ.) DOI: 10.31146/1682-8658-ecg-162-2-89-95
    Read & Download full text