1. Mоscow Research and Clinical Centre for TB Control, Moscow Healthcare Department, Moscow, Russia
2. Pirogov Russian National Research Medical University, Moscow, Russia

Keywords: abdominal tuberculosis, intestinal tuberculosis, HIV infection, tuberculosis peritonitis, bowel obstruction

Abstract: Aim. The aim of the research was to perform an analysis of surgical complications of abdominal tuberculosis and to determine optimal surgical treatment methods.
Materials and methods. A retrospective analysis of the treatment of 166 patients with surgical complications of abdominal tuberculosis was conducted: 60 HIV-negative patients of group I and 106 HIV-positive patients of group II. The patients underwent a comprehensive examination, which included diagnostic radiology, endoscopic methods, and the study of biological media for the detection of Mycobacterium tuberculosis. All patients underwent various types of urgent surgery.
Results. Perforations of tuberculosis ulcers of the intestine were diagnosed in 71 (42.8%) patients, tuberculosis peritonitis in 50 (30.1%), acute intestinal obstruction in 26 (15.7%), intestinal bleeding in 8 (4.8%), tuberculosis spleen abscesses - in 11 (6.6%). Analyzing our experience in treating patients with abdominal tuberculosis, it can be said that surgical complications are twice as likely to occur in HIV-positive patients, but the spectrum of the incidence of surgical complications does not differ.
Conclusions. The most frequent surgical complications of abdominal tuberculosis in both patients with HIV-negative and in patients with HIV-positive status are perforations of intestinal tuberculosis ulcers, tuberculosis peritonitis and acute intestinal obstruction, which lead to the development of severe surgical complications, causing the complexity of diagnosis and treatment and high mortality. The tuberculosis lesions of various organs and systems were detected in HIV-positive patients 2.3 times more often; tuberculosis is of a generalized nature, associated with hematogenous dissemination and is accompanied by severe surgical complications.

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Full text is published :
Reshetnikov M. N., Plotkin D. V., Sinitsyn M. V., Gafarov U. O., Belentseva O. V. Surgical complications of abdominal tuberculosis in patients with diff erent immune status. Experimental and Clinical Gastroenterology. 2019;164(4): 46–53. (In Russ.) DOI: 10.31146/1682-8658-ecg-164-4-46-53
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1. State Budgetary Institution of Health Care “Region Clinic Hospital Nr 2” Health Ministry of Krasnodar Region, Krasnodar, Russia
2. Federal State Budgetary Educational Institution of Higher Education “Kuban State Medical University” Health Ministry of Russian Federation, Krasnodar, Russia

Keywords: cicatricial strictures, common bile duct, bougienage, choledochoscopy

Abstract: The aim was to optimize the method of endoscopic bougienage in common bile duct strictures using the oral choledochoscope.
Materials: the analysis of 177 patients with bile duct strictures of the main group and 38 patients of the comparison group. The nature and history of bile duct strictures, as well as the possibilities and effectiveness of application the oral choledochoscope in the narrowing of strictures in difficult clinical situations have been studied.
Results: the method proposed by us was applied in 5 patients, in complex clinical cases when, under X-ray control, it was not possible to hold the string conductor outside the stricture zone. Comparing the proportion of effective and ineffective minimally invasive interventions, a higher rate was observed in the main group by 12.1% (91.0%) than in the comparison group (78.9%) with a statistically significant difference in the proportions (p = 0.0329, t. e. p <0.05).
Conclusion: the introduction of the bougienage method with the choledochoscope allowed a statistically significant reduction in the failure rate of minimally invasive treatment of common bile duct strictures in the main group of observables.

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Full text is published :
Gabriel S. A., Durleshter V. M., Guchetl A. Ya., Dynko V. Yu., Bespechnyj M. V. The use of an oral choledochoscope for cicatricial strictures of the common bile duct. Experimental and Clinical Gastroenterology. 2019;164(4): 54–58. (In Russ.) DOI: 10.31146/1682-8658-ecg-164-4-54-58
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1. RUDN University, Moscow, Russia
2. Skobelkin state scientifi c center of laser medicine, Moscow, Russia
3. Herzen research oncological Institute, Moscow, Russia
4. Eramishantsev Clinical Hospital, Moscow, Russia

Keywords: malignant colon obstruction, colorectal stenting, bridge to surgery, IPMN, MCN, SCN, EUS

Abstract: Malignant colonic obstruction is actual problem of emergency surgery. In various clinical situations it is possible to perform different interventions. Colorectal stenting is the favorite method of palliative treatment. However, the role of stenting in patients with curable or potentially curable tumors remains unclear. This literature review presents data from meta-analysis, randomized and cohort studies, as well as recommendations to determine the role of colorectal stenting as bridge to surgery

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Full text is published :
Vodoleev A. S., Duvanskiy V. A., Yarotskov I. I. Colorectal stenting as a bridge to surgery for malignant colonic obstruction: evidence-based medicine. Experimental and Clinical Gastroenterology. 2019;164(4): 59–65. (In Russ.) DOI: 10.31146/1682-8658-ecg-164-4-59-65
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1. City clinical hospital № 24, Moscow, Russia
2. Moscow Regional Research and Clinical Institute (“MONIKI”), Moscow, Russia
3. Pirogov Russian National Research Medical University, Moscow, Russia

Keywords: low rectal cancer, magnetic resonance imaging, metastases, lymph nodes, extramural vascular invasion

Abstract: Rectal cancer occupies one of the leading places 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, the presence of extramural lymphovascular invasion, which is an important predictor of recurrence of the disease, as well as an indicator of the early appearance of distant metastases. The effectiveness and reliability of preoperative staging of the low rectal cancer has increased significantly after the introduction into clinical practice of magnetic resonance imaging, as well as a comprehensive preoperative radiation examination of patients. The article is devoted to the problems of preoperative staging and determination of statistically significant relationships between the presence of extramural vascular invasion in cancer of the low rectal cancer and the presence of distant metastases, the identification of the correlation between T and N - stages of the tumor, their morphological types with diagnosed extramural vascular invasion.

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Full text is published :
Volkova S. N., Stashuk G. A., Chermensky G. V., Naumov E. K. The role of MRI in identifying extramural vascular invasion as an indicator of the presence of regional and distant metastases of low rectal cancer. Experimental and Clinical Gastroenterology. 2019;164(4): 66–71. (In Russ.) DOI: 10.31146/1682-8658-ecg-164-4-66-71
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