Список литературы

2687-0940

Challenges in modern medicine

2687-0940

10.52575/2687-0940-2021-44-4-450-459

SURGERY

<strong>Transanal excision of the rectal mucosa vs transanal stapler resection (STARR procedure) for the correction of obstructed defecation in rectocele combined with the rectal mucosa prolapse</strong>

Krivchikova

Arina P.

Krivchikova

Arina P.

Iarosh

Andrey L.

Iarosh

Andrey L.

yarosh_a@bsuedu.ru

Oleynik

Natalia V.

Oleynik

Natalia V.

oleynik_nv@mail.ru

Gorbenko

Andrey G.

Gorbenko

Andrey G.

Bratisheva

Natalia N.

Bratisheva

Natalia N.

Karpachev

Aleksandr A.

Karpachev

Aleksandr A.

2021

44400

In 40 % of patients, rectocele occurs in combination with prolapse of the rectal mucosa. This combined pathology is clinically manifested by obstructive defecation syndrome. The aim of this study was to evaluate the efficacy and safety of transanal excision of the rectal mucosa with transanal stapler resection (STARR) in patients with this pathology. The patients hospitalized in the coloproctology department of the Belgorod Regional Clinical Hospital of St. Joasaph in 2019–2020 were divided into two groups of 30 people each by randomization. Group 1 consisted of 30 patients who underwent transanal resection of the rectal mucosa and anterior levatoroplasty. Group 2 consisted of 30 patients who underwent STARR surgery. The patients were examined a week, six and twelve months after the operation. The duration of the intervention, the severity of postoperative pain syndrome, hospital stay, postoperative complications, and the duration of the recovery period were evaluated. With the help of questionnaires, the continence, emptying function of intestinal contents was evaluated in comparison with the results of X-ray examination, quality of life. The authors noted no significant differences in the frequency of complications, long-term anatomical and functional results. However, the STARR technique is technically simpler, requires less time and terms of hospitalization, which compensates for its high cost.

ректоцелеопущение слизистой прямой кишкиобструктивная дефекациятрансанальное иссечениеметодика STARR

Список литературы

Kulikovckij V.F., Olejnik N.V. 2008. Tazovy`j prolapc u zhenshhin [Pelvic prolapse in women]. Mockva, GE`OTAR. 256 s.

Kulikovskij V.F., Olejnik N.V., Krivchikova A.P., Bratishheva N.N. 2018. Preimushhestva vnutribryushnoj sakrokol`porektopeksii, dopolnennoj steplernoj transanal`noj rezekciej slizistoj pryamoj kishki v xirurgicheskom lechenii tazovogo prolapse [The advantages of intra-abdominal sacrocolporectopexy combined with stapled trance anal resection of rectal mucosa in surgical treeatment of pelvic organ prolapse]. Nauchny`e vedomosti BelGU. Ser. Medicina. Farmaciya. 41 (1): 5–13.

Kulikovskij V.F., Olejnik N.V., Krivchikova A.P., Bratishheva N.N. 2018. Analiz prichin neudovletvoritel`ny`x rezul`tatov xirurgicheskogo lecheniya rektocele v zavisimosti ot vida operativnogo vmeshatel`stva [Analysis of the causes of unsatisfactory results of surgical treatment of rectocele depending on the type of surgical intervention] (tezisy` doklada nauchnoj konferencii). Koloproktologiya. 64 (2): 23. Materialy` vserossijskoj nauchno-prakticheskoj konferencii s mezhdunarodny`m uchastiem «Dostizheniya sovremennoj koloproktologii», Suzdal`, 23–25 avg. 2018 g.).

Olejnik N.V., Kulikovskij V.F., Naumov A.V., Storozhilov D.A., Krivchikova A.P., Bratishheva N.N. 2016. Sakrokol`popeksiya, rektopeksiya i metodika RRN v kompleksnom lechenii opu-shheniya tazovogo dna u zhenshhin [Sacrocolpopexy, rectopexy and RNR technique in the complex treatment of pelvic floor emptying in women] (tezisy` doklada nauchnogo s``ezda). Koloproktologiya. 2 (56), pril.: 36–37. – (Materialy` vserossijskogo S``ezda koloproktologov s mezhdunarodny`m uchastiem «Operativnaya i konservativnaya koloproktologiya: sovremenny`e texnologii dlya vy`sokogo kachestva zhizni pacienta» i Ob``edinennogo Kaspijskogo i Bajkal`skogo foruma po problemam VZK, Astraxan`, 25–27 avg. 2016 g.).

Fomenko O.Yu., Titov A.Yu., Biryukov O.M. 2016. Diagnostika i konservativnoe lechenie funkcional`ny`x rasstrojstv defekacii [Diagnosis and conservative treatment of functional disorders of defecation]. Koloproktologiya. 3 (57): 48–54.

Fomenko O.Yu. Shely`gin Yu.A., Popov A.A. 2017. Funkcional`noe sostoyanie my`shcz tazovogo dna u bol`ny`x rectocele [The functional state of the pelvic floor muscles in patients with rectocele]. Rossijskij vestnik akushera-ginekologa. 17(3): 43–48.

Azizi1 R., Alvandipour M., Sayadi S., Khodabakhsh H., Karami M. 2015. J. Mazandaran Univ. Med. Sci. 2015; 25 (132): 74–81.

Gentile M., De Rosa M., Cestaro G., Vitiello C., Sivero L. 2014. Internal Delorme vs. STARR procedure for correction of obstructed defecation from rectocele and rectal intussusception. Ann. Ital. Chir. 85: 177–183.

Giarratano G., Toscana C., Toscana E., Shalaby M., Sileri P. 2019. Stapled transanal rectal resection for the treatment of rectocele associated with obstructed defecation syndrome: a large series of 262 consecutive patients. Tech Coloproctol. 23 (3): 231–237.

Kulikovsky V.F., Oleynik N.V., Bratisheva N.N., Krivchikova A.P., Alenicheva M.S. 2018. Posterior colporrhaphy and levatoroplasty versus abdominal sacral colpopexy combined with stapled trance-anal resection (STARR) for the surgical treatment of rectocele concomitant with rectal mucosal prolapse. International Journal of Advanced Biotechnology and Research. 9 (1): 1022–1027.

Kulikovsky V.F., Oleynik N.V., Krivchikova A.P., Bratisheva N.N., Alenicheva M.S. 2018. Posterior Colporrhaphy and Levatoroplasty versus Ab-dominal Sacral Colpopexy Combined with Stapled Trance-anal Resection (STARR) for the Surgical Treatment of Rectocele Con-comitant with Rectal Mucosal Prolapse. International Journal of Advanced Biotechnology and Research (IJBR). 9 (1): 1022–1027.

Kulikovsky V.F., Oleynik N.V., Storogilov D.A., Naumov A.V., Krivchikova A.P., Bratisheva N.N. 2016. The advantages of the abdominal sacral colpopexy combined with Stapled Trance-Anal Resection of the Rectal Mucosal Prolapse (STARR) for the surgical treatment of perineum descending syndrome. International Journal of Pharmacy and Technology. 8 (4): 26909–26920.

Lehur P.A., Pravini B., Christoforidis D. 2020. To staple or not to staple the symptomatic rectocele. Tech Coloproctol. 24 (1): 1–3.

Liu W.C., Wan S.L., Yaseen S.M., Ren X.H., Tian C.P., Ding Z., Zheng K.Y., Wu Y.H., Jiang C.Q., Qian Q. 2016. Transanal surgery for obstructed defecation syndrome: Literature review and a single-center experience. World J. Gastroenterol. 22 (35): 7983–7998.

Rao S.S.C., Tetangco E.P. 2020. Anorectal Disorders: An Update. J. Clin. Gastroenterol. 54 (7): 606–613.

Schwandner O. 2016. Symptoms, diagnostics and therapy concepts from a coloproctological viewpoint. Chirurg. 87 (11): 985–998.

Schwandner O., Hillemanns P. 2016. Indications, technique and results of the STARR procedure. Chirurg. 87 (11): 909–917.

Shafik A.A., El Sibai O., Shafik I.A. 2016. Rectocele repair with stapled transvaginal rectal resection. Tech Coloproctol. 20 (4): 207–214.

Tsunoda A., Takahashi T., Kusanagi H. 2020. Transanal repair of rectocele: prospective assessment of functional outcome and quality of life. Colorectal Dis. 22 (2): 178–186.

Zhumanova E.N., Koneva E.S., Epifanov V.A., Korchazhkina N.B., Illarionov V.E., Elfimov M.A., Lyadov K.V. 2020. Influence of various rehabilitation complexes on sexual function in fertile females and women of perimenopausal and menopausal age after surgery for rectocele]. Khirurgiia (Mosk). 12: 76–82.