spracticeХирургическая практикаSurgical practice (Russia)2223-2427АНО "Консорциум "Медицинская техника"10.5922/2223-2427-2024-9-4-5spractice-515Research ArticleОБЗОРЫ ЛИТЕРАТУРЫСовременный подход к диагностике и лечению пациентов с медленно-транзитным запором: обзор литературыPathophysiology, diagnostics and treatment of slow-transit constipation: a reviewhttps://orcid.org/0000-0003-2330-4229ГармановаТ. Н.GarmanovaT. N.

Татьяна Николаевна Гарманова, кандидат медицинских наук, доцент кафедры хирургии факультета фундаментальной медицины

119991, Москва, ул. Ленинские горы, 1

Tatiana N. Garmanova, Associate Professor, Department of Surgery, Faculty of Medicine

1 Leninskie Gory, Moscow, 119991

tatianagarmanova@gmail.comhttps://orcid.org/0000-0003-2711-2400МаркарьянД. Р.MarkaryanD. R.

Даниил Рафаэлевич Маркарьян, кандидат медицинских наук, доцент кафедры хирургии факультета фундаментальной медицины

119991, Москва, ул. Ленинские горы, 1

Daniil R. Markaryan, Associate Professor, Department of Surgery, Faculty of Medicine

1 Leninskie Gory, Moscow, 119991

dmarkaryan@gmail.comhttps://orcid.org/0000-0002-2768-4305ЛукьяновА. М.LukianovA. M.

Александр Максимович Лукьянов, аспирант кафедры хирургии факультета фундаментальной медицины

119991, Москва, ул. Ленинские горы, 1

Alexander M. Lukianov, PhD student, Department of Surgery, Faculty of Medicine

1 Leninskie Gory, Moscow, 119991

alexmaxl@mail.ruhttps://orcid.org/0000-0001-6322-7016КазаченкоЕ. А.KazachenkoE. A.

Екатерина Александровна Казаченко, аспирант кафедры хирургии факультета фундаментальной медицины

119991, Москва, ул. Ленинские горы, 1

Ekaterina A. Kazachenko, PhD student, Department of Surgery, Faculty of Medicine

1 Leninskie Gory, Moscow, 119991

ekaterina.k.97@mail.ruhttps://orcid.org/0009-0007-8162-506XУхановП. Г.UhanovP. G.

Петр Григорьевич Уханов, клинический ординатор факультета фундаментальной медицины

119991, Москва, ул. Ленинские горы, 1

Petr G. Ukhanov, Clinical Resident, Department of Surgery, Faculty of Medicine

1 Leninskie Gory, Moscow, 119991

nitrogenium42@gmail.comhttps://orcid.org/0009-0002-5429-8861БековаЗ. М.BekovaZ. M.

Заира Магомедовна Бекова, клинический ординатор факультета фундаментальной медицины

119991, Москва, ул. Ленинские горы, 1

Zaira M. Bekova, Clinical Resident, Department of Surgery, Faculty of Medicine

1 Leninskie Gory, Moscow, 119991

Московский государственный университет имени М. В. ЛомоносоваРоссияLomonosov Moscow State UniversityRussian Federation202414122024045974Copyright © Гарманова Т.Н., Маркарьян Д.Р., Лукьянов А.М., Казаченко Е.А., Уханов П.Г., Бекова З.М., 20242024Гарманова Т.Н., Маркарьян Д.Р., Лукьянов А.М., Казаченко Е.А., Уханов П.Г., Бекова З.М.Garmanova T.N., Markaryan D.R., Lukianov A.M., Kazachenko E.A., Uhanov P.G., Bekova Z.M.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/515Введение

Введение. Работа представляет из себя обзорную статью, посвященную проблеме медленно-транзитных запоров: их патофизиологии, диагностике, выбору и вариативности методов лечения.

Цель

Цель. Определить понятие медленно-транзитных запоров, описать основные патофизиологические механизмы их формирования, выделить ключевые аспекты диагностики данного состояния, а также обосновать и подробно рассмотреть существующие методы лечения и их клиническую эффективность.

Материалы и методы

Материалы и методы. Проведен систематический поиск литературы по электронным базам данных (PubMed, EMBASE, Cochrane) за последние 20 лет. В обзор включались исследования, посвященные клиническим исходам и патофизиологическим механизмам развития медленно-транзитных запоров. Поиск литературы осуществлялся по следующим ключевым словам: медленно-транзитный запор, хронический запор, диагностика запоров, лечение запоров, хирургическое лечение запоров. Обзор подготовлен в соответствии с рекомендациями PRISMA.

Результаты

Результаты. Несмотря на то что консервативная терапия при лечении хронических идиопатических запоров является методом выбора, эффективность как медикаментозной, так и немедикаментозной терапии в отношении лечения медленно-транзитных запоров минимальна. В то же время радикальное хирургическое лечение приносит значительный эффект в снижении симптоматики заболевания и улучшении качества жизни, что ставит вопрос о предпочтительности хирургического метода лечения медленно-транзитных запоров. Аспекты, касающиеся частоты послеоперационных осложнений и выбора наиболее подходящего варианта оперативного лечения, остаются недостаточно исследованными, что оставляет вопрос о предпочтительном варианте открытым для дальнейшего изучения.

Заключение

Заключение. Установлена ограниченная эффективность консервативной терапии при медленно-транзитных запорах, при том что радикальное хирургическое лечение приводит к значительному улучшению симптомов и качества жизни. Это требует дальнейших исследований для оптимизации подходов к лечению и изучения послеоперационных осложнений.

Introduction

Introduction. The work is a review article that examines the pathophysiology, diagnostics and treatment options for slow-transit constipation.

Aim

Aim. The main goal of this study is to define slow-transit constipation, describe the primary pathophysiological mechanisms involved in its development, identify key aspects of diagnosing the condition, and thoroughly examine the existing treatment methods and their clinical efficacy.

Methods

Methods. A systematic search of the literature in electronic databases PubMed, EMBASE and Cochrane covering the past 20 years was conducted. Studies on clinical outcomes and pathophysiological mechanisms of slow-transit constipation were included in this review prepared in accordance with PRISMA guidelines.

Results

Results. It has been established that, despite the widespread use of conservative therapy for idiopathic chronic constipation, its effectiveness in treating slow-transit constipation is low. Conversely, surgical treatment shows high effectiveness in improving symptoms and quality of life. This brings  up the question about making surgical approach the method of preference in treating slow-transit constipation. Yet, aspects related to the frequency of postoperative complications and the selection of the most appropriate surgical approach remain underexplored, leaving the question of the preferred option open for further investigation.

Conclusion

Conclusion. Despite the limited efficacy of conservative therapy for slow-transit constipation, radical surgical treatment shows significant improvement in symptoms and quality of life, requiring further studies to optimise treatment approaches and investigate postoperative complications.

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