spracticeХирургическая практикаSurgical practice (Russia)2223-2427АНО "Консорциум "Медицинская техника"10.38181/2223-2427-2022-4-15-22spractice-360Research ArticleСтатьиЛАПАРОСКОПИЧЕСКАЯ ИЛЕОЦЕКАЛЬНАЯ РЕЗЕКЦИЯ В ЛЕЧЕНИИ БОЛЕЗНИ КРОНА: ОПЫТ МКНЦ ИМ. А.С. ЛОГИНОВАLAPAROSCOPIC ILEOCECAL RESECTION OF CROHN'S DISEASE: THE EXPERIENCE OF THE MOSCOW CLINICAL RESEARCH CENTERhttps://orcid.org/0000-0001-9439-9873ДаниловМ. А.DanilovM. A.

Данилов Михаил Александрович – к.м.н., зав. отделением колопроктологии

шоссе Энтузиастов, 86, 111123, Москва

PhD; Head of the Department of Coloproctology

Shosse Entuziastov, 86, Moscow 111123

m.danilov@mknc.ruhttps://orcid.org/0000-0003-3363-6841ЛеонтьевА. В.LeontyevA. V.

Леонтьев Александр Владимирович – к.м.н., врач-колопроктолог

шоссе Энтузиастов, 86, 111123, Москва

PhD; Coloproctologist

Shosse Entuziastov, 86, Moscow 111123

a.leontev@mknc.ruhttps://orcid.org/0000-0003-3363-6841БайчоровА. Б.BaichorovA. B.

Байчоров Аслан Борисович – к. м. н., врач-колопроктолог

шоссе Энтузиастов, 86, 111123, Москва

PhD; Coloproctologist

Shosse Entuziastov, 86, Moscow 111123

a.baichorov@mknc.ruhttps://orcid.org/0000-0002-8599-8089АбдулатиповаЗ. М.AbdulatipovaZ. M.

Абдулатипова Заира Магомедовна – к.м.н., врач–колопроктолог

шоссе Энтузиастов, 86, 111123, Москва

PhD; Coloproctologist

Shosse Entuziastov, 86, Moscow 111123

z.abdulatipova@yandex.ruhttps://orcid.org/0000-0001-5436-3630СаакянГ. Г.SaakyanG. G.

Саакян Георгий Германович – врач–колопроктолог

шоссе Энтузиастов, 86, 111123, Москва

Coloproctologist

Shosse Entuziastov, 86, Moscow 111123

g.saakian@mknc.ruhttps://orcid.org/0000-0001-5141-1692ДемидоваА. А.DemidovaA. A.

Демидова Анастасия Александровна – аспирант отделения колопроктологии

шоссе Энтузиастов, 86, 111123, Москва

тел.: +7-906-629-25-90

PhD-Student of the Department of Coloproctology

 Shosse Entuziastov, 86, Moscow 111123

anastasia.demidova0808@gmail.comГБУЗ г. Москвы «Московский клинический научно-практический центр им. А.С. Логинова Департамента здравоохранения г. Москвы»РоссияMoscow Clinical Research CenterRussian Federation202208122022041522Copyright © Данилов М.А., Леонтьев А.В., Байчоров А.Б., Абдулатипова З.М., Саакян Г.Г., Демидова А.А., 20222022Данилов М.А., Леонтьев А.В., Байчоров А.Б., Абдулатипова З.М., Саакян Г.Г., Демидова А.А.Danilov M.A., Leontyev A.V., Baichorov A.B., Abdulatipova Z.M., Saakyan G.G., Demidova A.A.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/360

Введение: самым распространенным хирургическим вмешательством при осложненных формах болезни Крона является илеоцекальная резекция. Данная операция выполняется в плановом порядке при неэффективности медикаментозной терапии, а также экстренно, при развитии кишечной непроходимости или септических осложнениях. В подавляющем большинстве случаев есть возможность выполнить лапароскопический доступ, тем самым снизив риски и ускорив восстановление пациента в послеоперационном периодеЦель: оценка результатов лапароскопической илеоцекальной резекции у пациентов с болезнью КронаМатериалы и методы: в исследование включены 46 пациентов (21 женщина, 25 мужчин), которым выполнялась лапароскопическая илеоцекальная резекция по поводу стриктурирующей формы болезни Крона. 18 пациентов оперированы по экстренным показаниям, 28 – в плановом порядке. Средний возраст 37,6 лет.Результаты: конверсия в лапаротомию была выполнена у 4 пациентов (8,7 %), среднее время операции составило 128,2 минуты. Осложнения, потребовавшие повторного вмешательства, были у 3 пациентов (6,5 %). У 4 пациентов (8,7 %) были гнойно-септические осложненияВыводы: лапароскопическая илеоцекальная резекция при стриктурирующей форме болезни Крона на наш взгляд является простой, легко воспроизводимой операцией, как при плановых оперативных вмешательствах, так и в экстренных случаях.

Background: the most common surgical intervention for complicated forms of Crohn's disease is ileocecal resection. This operation is performed in a planned manner with the ineffectiveness of conservative therapy. Also, the operation is performed according to emergency indications with the development of intestinal obstruction or septic complications. In the vast majority of cases, it is possible to perform a laparoscopic approach, thereby reducing the risks of complications and accelerating the recovery of the patient in the postoperative period.Aim: evaluation of the results of laparoscopic ileocecal resection in patients with Crohn's diseaseMaterials and methods: the study included 46 patients (21 women, 25 men) who underwent laparoscopic ileocecal resection for the stricture form of Crohn's disease. 18 patients were operated on for emergency indications, 28 – for planned indications. The mean age was 37.6 year.Results: conversion to laparotomy was performed in 4 patients (8.7%). The mean operative time was 128.2 minutes. Complications that required reoperation were in 3 patients (6.5%). 4 patients (8.7%) had purulent-septic wound complications.Conclusion: laparoscopic ileocecal resection for stricture Crohn's disease is a simple, easily reproducible operation, both in planned surgical interventions and in emergency cases.

болезнь Кронастриктураилеоцекальная резекциябрыжейкалапароскопияCrohn's diseasestrictureileocecal resectionmesenterylaparoscopyReferencesSiassi M, Weiger A, Hohenberger W, Kessler H. Changes in surgical therapy for Crohn's disease over 33 years: a prospective longitudinal study. Int J Colorectal Dis. 2007 Mar; 22(3):319-24. https://doi.org/10.1007/s00384-006-0150-5Siassi M, Weiger A, Hohenberger W, Kessler H. Changes in surgical therapy for Crohn's disease over 33 years: a prospective longitudinal study. Int J Colorectal Dis. 2007 Mar; 22(3):319-24. https://doi.org/10.1007/s00384-006-0150-5Radford-Smith GL. What is the importance of appendectomy in the natural history of IBD? Inflamm Bowel Dis. 2008 Oct;14 Suppl 2:S72-4. https://doi.org/10.1002/ibd.20623Radford-Smith GL. What is the importance of appendectomy in the natural history of IBD? Inflamm Bowel Dis. 2008 Oct;14 Suppl 2:S72-4. https://doi.org/10.1002/ibd.20623Di Fede G, Bronte G, Rizzo S, Rolfo Cervetto C, Cocorullo G, Gulotta G, Bazan V, Russo A. Monoclonal antibodies and antibody fragments: state of the art and future perspectives in the treatment of non-haematological tumors. Expert Opin Biol Ther. 2011 Nov;11(11):1433-45. https://doi.org/10.1517/14712598.2011.594436Di Fede G, Bronte G, Rizzo S, Rolfo Cervetto C, Cocorullo G, Gulotta G, Bazan V, Russo A. Monoclonal antibodies and antibody fragments: state of the art and future perspectives in the treatment of non-haematological tumors. Expert Opin Biol Ther. 2011 Nov;11(11):1433-45. https://doi.org/10.1517/14712598.2011.594436Белоусова Е. А. Рекомендации по диагностике и лечению болезни Крона. Фарматека. 2009.T. 13. C. 38-44. [E. Belousova. Recommendations for the diagnosis and treatment of Crohn's disease. Farmateka 187.13 (2009): 38-44. (In Russ.)]Белоусова Е. А. Рекомендации по диагностике и лечению болезни Крона. Фарматека. 2009.T. 13. C. 38-44. [E. Belousova. Recommendations for the diagnosis and treatment of Crohn's disease. Farmateka 187.13 (2009): 38-44. (In Russ.)]Соловьев И.А., Курило Д.П. Тактика хирургического лечения осложнений болезни Крона. Вестник Российской военно-медицинской академии. 2018. T. 1, № 61. C. 111-116. [Soloviev, I. A., Kurilo D.P. Tactics of surgical treatment of complications of Crohn’s disease. Bulletin of the Russian Military Medical Academy (2018): 111-116. (In Russ.)]Соловьев И.А., Курило Д.П. Тактика хирургического лечения осложнений болезни Крона. Вестник Российской военно-медицинской академии. 2018. T. 1, № 61. C. 111-116. [Soloviev, I. A., Kurilo D.P. Tactics of surgical treatment of complications of Crohn’s disease. Bulletin of the Russian Military Medical Academy (2018): 111-116. (In Russ.)]Coffey CJ, Kiernan MG, Sahebally SM, Jarrar A, Burke JP, Kiely PA, Shen B, Waldron D, Peirce C, Moloney M, Skelly M, Tibbitts P, Hidayat H, Faul PN, Healy V, O'Leary PD, Walsh LG, Dockery P, O'Connell RP, Martin ST, Shanahan F, Fiocchi C, Dunne CP. Inclusion of the Mesentery in Ileocolic Resection for Crohn's Disease is Associated With Reduced Surgical Recurrence. J Crohns Colitis. 2018 Nov 9;12(10):1139-1150. https://doi.org/10.1093/ecco-jcc/jjx187Coffey CJ, Kiernan MG, Sahebally SM, Jarrar A, Burke JP, Kiely PA, Shen B, Waldron D, Peirce C, Moloney M, Skelly M, Tibbitts P, Hidayat H, Faul PN, Healy V, O'Leary PD, Walsh LG, Dockery P, O'Connell RP, Martin ST, Shanahan F, Fiocchi C, Dunne CP. Inclusion of the Mesentery in Ileocolic Resection for Crohn's Disease is Associated With Reduced Surgical Recurrence. J Crohns Colitis. 2018 Nov 9;12(10):1139-1150. https://doi.org/10.1093/ecco-jcc/jjx187Yamamoto T. Factors affecting recurrence after surgery for Crohn's disease. World J Gastroenterol. 2005 Jul 14;11(26):3971-9. https://doi.org/10.3748/wjg.v11.i26.3971Yamamoto T. Factors affecting recurrence after surgery for Crohn's disease. World J Gastroenterol. 2005 Jul 14;11(26):3971-9. https://doi.org/10.3748/wjg.v11.i26.3971Vettoretto N, Gazzola L, Giovanetti M. Emergency laparoscopic ileocecal resection for Crohn's acute obstruction. JSLS. 2013 Jul-Sep;17(3):499-502. https://doi.org/10.4293/108680813X13693422521872Vettoretto N, Gazzola L, Giovanetti M. Emergency laparoscopic ileocecal resection for Crohn's acute obstruction. JSLS. 2013 Jul-Sep;17(3):499-502. https://doi.org/10.4293/108680813X13693422521872Nahon S., Bouhnik Y., Lavergne-Slove A., Bitoun A., Panis Y., Valleur P., Vahedi K., Messing B., Matuchansky C., Rambaud J. C. Colonoscopy accurately predicts the anatomical severity of colonic Crohn's disease attacks: correlation with findings from colectomy specimens. Am J Gastroenterol. 2002. V. 97, №12. P. 3102-7.Nahon S., Bouhnik Y., Lavergne-Slove A., Bitoun A., Panis Y., Valleur P., Vahedi K., Messing B., Matuchansky C., Rambaud J. C. Colonoscopy accurately predicts the anatomical severity of colonic Crohn's disease attacks: correlation with findings from colectomy specimens. Am J Gastroenterol. 2002. V. 97, №12. P. 3102-7.Tilney HS, Constantinides VA, Heriot AG, Nicolaou M, Athanasiou T, Ziprin P, Darzi AW, Tekkis PP. Comparison of laparoscopic and open ileocecal resection for Crohn's disease: a metaanalysis. Surg Endosc. 2006 Jul;20(7):1036-44. https://doi.org/10.1007/s00464-005-0500-3Tilney HS, Constantinides VA, Heriot AG, Nicolaou M, Athanasiou T, Ziprin P, Darzi AW, Tekkis PP. Comparison of laparoscopic and open ileocecal resection for Crohn's disease: a metaanalysis. Surg Endosc. 2006 Jul;20(7):1036-44. https://doi.org/10.1007/s00464-005-0500-3Patel SV, Patel SV, Ramagopalan SV, Ott MC. Laparoscopic surgery for Crohn's disease: a meta-analysis of perioperative complications and long term outcomes c ompared with open surgery. BMC Surg. 2013 May 24;13:14. https://doi.org/10.1186/1471-2482-13-14Patel SV, Patel SV, Ramagopalan SV, Ott MC. Laparoscopic surgery for Crohn's disease: a meta-analysis of perioperative complications and long term outcomes c ompared with open surgery. BMC Surg. 2013 May 24;13:14. https://doi.org/10.1186/1471-2482-13-14Cocorullo G, Tutino R, Falco N, Salamone G, Gulotta G. Three-port colectomy: reduced port laparoscopy for general surgeons. A single center experience. Ann Ital Chir. 2016;87:350-355.Cocorullo G, Tutino R, Falco N, Salamone G, Gulotta G. Three-port colectomy: reduced port laparoscopy for general surgeons. A single center experience. Ann Ital Chir. 2016;87:350-355.He X, Chen Z, Huang J, Lian L, Rouniyar S, Wu X, Lan P. Stapled side-to-side anastomosis might be better than handsewn end-to-end anastomosis in ileocolic resection for Crohn's disease: a meta-analysis. Dig Dis Sci. 2014 Jul;59(7):1544-51. https://doi.org/10.1007/s10620-014-3039-0He X, Chen Z, Huang J, Lian L, Rouniyar S, Wu X, Lan P. Stapled side-to-side anastomosis might be better than handsewn end-to-end anastomosis in ileocolic resection for Crohn's disease: a meta-analysis. Dig Dis Sci. 2014 Jul;59(7):1544-51. https://doi.org/10.1007/s10620-014-3039-0

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