spracticeХирургическая практикаSurgical practice (Russia)2223-2427АНО "Консорциум "Медицинская техника"10.38181/issn2223-2427.2019.4.18-31spractice-129Research ArticleСтатьиГЛУБОКИЙ ИНФИЛЬТРАТИВНЫЙ ЭНДОМЕТРИОЗ РЕКТОВАГИНАЛЬНОЙ ПЕРЕГОРОДКИ С ВОВЛЕЧЕНИЕМ ПРЯМОЙ КИШКИ. СОВРЕМЕННОЕ СОСТОЯНИЕ ПРОБЛЕМЫDEEP INFILTRATIVE ENDOMETRIOSIS OF THE RECTOVAGINAL SEPTUM INVOLVING THE RECTUM. CURRENT STATE OF THE PROBLEMГаллямовЭ. А.GalliamovE. A.

Галлямов Эдуард Абдулхаевич – д.м.н., профессор, заведующий кафедрой общей хирургии

Большая Пироговская ул., д. 19 стр. 1, 119146, Москва

Galliamov Eduard Abdulhaevich – MD, Professor, Head of the General Surgery Department

Bolshaya Pirogovskaya St., 19/1, 119146, Moscow

gal_svetlana@mail.ruУнанянА. Л.UnanyanA. L.

Унанян Ара Леонидович – д.м.н., профессор кафедры акушерства и гинекологии №1

Большая Пироговская ул., д. 19 стр. 1, 119146, Москва

Unanyan Ara Leonidovich – MD, Professor of the Department of obstetrics and gynecology №1

Bolshaya Pirogovskaya St., 19/1, 119146, Moscow

АгаповМ. А.AgapovM. A.

Агапов Михаил Андреевич – д.м.н., профессор кафедры хирургии ФФМ

Ул. Ленинские Горы, д. 1, 119991, Москва

Agapov Mihail Andreevich – MD, Professor of the Department of Surgery

Leninskie Gory St., 1, 119991, Moscow

getinfo911@mail.ruАминоваЛ. Н.AminovaL. N.

Аминова Лиана Назимовна – к.м.н., заведующая гинекологическим отделением

2-й Боткинский проезд, 5–3, 5–4, 125284, Москва

Aminova Liana Nazimovna – PhD, head of the Department of Gynecology

2-y Botkinskiy proezd, 5–3, 5–4, 125284, Moscow

АлимовВ. А.AlimovV. A.

Алимов Владислав Александрович – врач акушер-гинеколог гинекологического отделения

2-й Боткинский проезд, 5–3, 5–4, 125284, Москва

Alimov Vladimir Aleksandrovich – gynecologist of the Department of Gynecology

2-y Botkinskiy proezd, 5–3, 5–4, 125284, Moscow

МурзинаА. Г.MurzinaA. G.

Мурзина Анна Геннадьевна – врач акушер-гинеколог гинекологического отделения

2-й Боткинский проезд, 5–3, 5–4, 125284, Москва

Murzina Anna Gennadievna – gynecologist of the Department of Gynecology

2-y Botkinskiy proezd, 5–3, 5–4, 125284, Moscow

КакоткинВ. В.KakotkinV. V.

Какоткин Виктор Викторович – клинический ординатор кафедры хирургии ФФМ

Ул. Ленинские Горы, д. 1, 119991, Москва

Kakotkin Viktor Viktorovich – Resident of the Department of Surgery of the Faculty of Medicine

Leninskie Gory St., 1, 119991, Moscow

axtroz4894@gmail.comПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияFederal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University (Sechenov University)Russian FederationМосковский государственный университет имени М.В. ЛомоносоваРоссияFederal State Budget Educational Institution of Higher Education M.V. Lomonosov Moscow State University (Lomonosov MSU)Russian FederationАО «Группа компаний «Медси»РоссияJoint Stock Company "Medsi group"Russian Federation201920042020041831Copyright © Галлямов Э.А., Унанян А.Л., Агапов М.А., Аминова Л.Н., Алимов В.А., Мурзина А.Г., Какоткин В.В., 20202020Галлямов Э.А., Унанян А.Л., Агапов М.А., Аминова Л.Н., Алимов В.А., Мурзина А.Г., Какоткин В.В.Galliamov E.A., Unanyan A.L., Agapov M.A., Aminova L.N., Alimov V.A., Murzina A.G., Kakotkin V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.spractice.ru/jour/article/view/129

Глубокий инфильтративный эндометриоз является распространенным заболеванием, затрагивающим молодых социально активных женщин. Актуальность проблемы глубокого инфильтративного эндометриоза обусловлена сложностью диагностики, отсутствием единой классификации заболевания и, как следствие, отсутствием единой стратегии ведения таких пациенток. Значимость инфильтративного эндометриоза подчеркивается тем, что как правило, это мультидисциплинарные оперативные вмешательства высокой степени сложности, особенностью которых часто является невозможность на предоперационном этапе сориентироваться в отношении окончательного объема хирургического вмешательства. В структуре хирургических вмешательств операции по поводу глубокого инфильтративного эндометриоза имеют сравнительно высокий процент осложнений и в контексте операций, улучшающих качество жизни, имеют немало спорных аспектов. За годы развития лапароскопической хирургии подход к оперативным вмешательствам по поводу глубокого инфильтративного эндометриоза изменился, характер вмешательств стремится к радикальности с одновременной выработкой алгоритмов, обеспечивающих безопасность пациентов. На сегодняшний день не существует не только полноценной классификации заболевания, но и, как следствие, не существует единой стратегии ведения пациенток с глубоким инфильтративным эндометриозом. Международный опыт врачей гинекологов, описанный в приведенных ниже публикациях, собран с глубокого инфильтративного эндометриоза имеют сравнительно высокий процент осложнений и в контексте операций, улучшающих качество жизни, имеют немало спорных аспектов. За годы развития лапароскопической хирургии подход к оперативным вмешательствам по поводу глубокого инфильтративного эндометриоза изменился, характер вмешательств стремится к радикальности с одновременной выработкой алгоритмов, обеспечивающих безопасность пациентов. На сегодняшний день не существует не только полноценной классификации заболевания, но и, как следствие, не существует единой стратегии ведения пациенток с глубоким инфильтративным эндометриозом. Международный опыт врачей гинекологов, описанный в приведенных ниже публикациях, собран с целью сопоставления накопленных на современном этапе знаний о проблеме глубокого инфильтративного эндометриоза ректовагинальной перегородки с вовлечением прямой кишки.

Deep infiltrative endometriosis is a common disease affecting young socially active women. The urgency of the problem of deep infiltrative endometriosis is due to the complexity of diagnosis, the lack of a unified classification of the disease and, as a consequence, the lack of a unified strategy for the management of such patients. The importance of infiltrative endometriosis is emphasized by the fact that, as a rule, it is a multidisciplinary surgical intervention of high complexity, a feature of which is often the inability to determine the final volume of surgical intervention at the preoperative stage. In the structure of surgical interventions, surgeries for deep infiltrative endometriosis have a relatively high percentage of complications and in the context of operations that improve the quality of life, have many controversial aspects. Over the years of laparoscopic surgery, the approach to surgical interventions for deep infiltrative endometriosis has changed; the nature of interventions tends to be radical, while developing algorithms that ensure the safety of patients. To date, there is not only a complete classification of the disease, but, as a result, there is no single strategy for managing patients with deep infiltrative endometriosis. The international experience of gynecologists was compiled with the aim of comparing the knowledge accumulated at the present stage about the problem of deep infiltrative endometriosis of the rectovaginal septum with the involvement of the rectum.

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The authors declare that there are no conflicts of interest present.