Authors
Ruziboyzoda K.R., Gulov M.K., Gulov A.A., Nurzoda Z.M.
Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
Abstract
Aim. Improving treatment outcomes for patients undergoing resection and reconstructive interventions on the colon by improving methods for preventing colonic anastomosis failure.
Materials and methods. The study included 96 patients undergoing treatment for colon diseases. Seventy-seven patients underwent resection with primary interintestinal anastomosis, while 19 patients underwent closure of previously established stomas, which is considered reconstructive surgery. To analyze the frequency of early postoperative complications, all patients were divided into two groups: main and control. In the main group, consisting of 47 patients, specially developed preventive and therapeutic measures were used in the postoperative period to reduce the risk of colonic anastomotic leakage (CAL). The control group included 49 patients who, after resection and reconstructive operations on the colon, received standard medical care based on generally accepted principles for managing such patients.
Results. In patients of the main group (n = 47), in the early postoperative period, the developed methods for the prevention of CAL were used: transcolonal local laser stimulation, transcolonal local administration of the antiseptic decasan, dynaton and mexidol, as well as NO-containing drugs in the area of the formed colonic anastomosis. Patients in the control group (n = 49) received standard, generally accepted treatment in the early postoperative period without the use of developed methods for preventing CAL. No cases of CAL were observed in the study group in the early postoperative period, whereas CAL developed in 4 patients (8.1%) in the control group.
Conclusion. Thus, the proposed methods for preventing colonic anastomotic failure contribute to improving the results of resection and reconstructive interventions on the colon due to timely healing of the anastomotic line and a reduction in the incidence of infectious and inflammatory postoperative complications, including cases of anastomotic failure.
Keywords: large intestine, resection and restorative interventions, colonic anastomotic failure, prevention.
References
1. Anishchenko V.V., Kim D.A. Subtotal colectomy in patients with chronic colostasis on the background of dolichocolon. Endoscopic surgery. 2020; 26(6): 12-16. (In Russ).
2. Rakhmanov ST, Navruzov BS. Results of surgical treatment of chronic colonic stasis. Coloproctology. 2014; 3(49): 96-97. (In Russ).
3. Alekseev MV, Rybakov EG, Shelygin YuA. A Study investigating the perfusion of colorectal anastomoses using FLuorescence AnGiography: results of FLAG randomized trial. Colorectal Disease. 2020; 22(9): 1147-1153.
4. Sergatsky KI, Dukhovnova KM, Ulybina DV, Malyakin IV, Lazutov EA, Gavryushin MA. Prediction of anastomotic leakage in colorectal surgery. News of higher educational institutions. Volga region. Medical sciences. 2025; 2: 51-61. (In Russ.)
5. Khasanov AG, Sufiyarov IF, Bakirov ER, Yamalova GR. Failure of sutures of colonic anastomoses. Medical Bulletin of Bashkortostan. 2020; 15(1): 75-79. (In Russ.)
6. Agaev EK, Ismaylova ZE, Mamedov TE. Prevention of intestinal anastomosis suture failure. Surgical News. 2022; 30(1): 86-94. (In Russ.)
7. Sciuto A., Merola G., De Palma G. D., Sodo M., Pirozzi F., Bracale U. M., Bracale U. Predictive factors for anastomotic leakage after laparoscopic colorectal surgery. World Journal of Gastroenterology. 2018; 24(21): 2247-2260.
8. Plecheva DV, Galimov OV, Plechev VV, Shikova YuV, Elova EV. Prevention of interintestinal anastomotic leakage in planned and urgent surgery. Bulletin of the Pirogov National Medical and Surgical Center. 2018; 13(3): 47-49. (In Russ.)
9. Berezovskaya TP, Myalina SA, Daineko YaA, Nevolskikh AA, Ivanov SA. Colorectal anastomotic failure: the role and possibilities of radiological diagnostics (literature review). Coloproctology. 2021; 20(2): 74-84. (In Russ.)
10. Chernykh MA, Belousov AM, Shostka KG. Colonic anastomotic insufficiency: current state of the problem and prospects for early diagnosis. Innovative Medicine of Kuban. 2024; 9(3): 131-138. (In Russ.)
11. Vainer YuS, Babyuk AE, Averkin PI, et al. Prevention of leakage of small-colonic anastomoses in emergency surgery. Experimental and clinical gastroenterology. 2020; 10: 123-128. (In Russ.)
12. Sultanmuradov MI, Groshilin VS, Tsygankov PV, Mrykhin GA. Prevention of mechanical colorectal anastomosis leak in colostomy reversal after Hartmann procedure. Endoscopic Surgery. 2018; 24(3): 21‑26. (In Russ.)
