Authors
Gulov M.K., Nurzoda Z.M., Ruziboyzoda K.R.
Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
Abstract
Aim. Improving the results of treatment of patients with chronic cologenic stasis by applying a differentiated approach to treatment.
Materials and methods. The study analyzed the results of complex treatment of 194 patients with various stages of chronic cologenic stasis (CCS). Patients with CCS were divided into 3 groups depending on the stage of the disease. The CCS group included 21 (10.8%) patients in the compensated stage, 119 (61.4%) patients in the subcompensation stage, and 54 (27.8%) patients in the decompensated stage of CCS. In 19 cases (9.8%), CCS was accompanied by various pathologies that led to its development and were combined with insufficiency of the bauhinium valve.
Results. The study found that complex conservative treatment was effective in 25 cases (12.9%): in 21 cases (100%) with a compensated stage and in 4 cases (3.4%) with a subcompensated stage of constipation that arose against the background of dolichosigma. At the same time, 169 patients (87.1%) with CCS in the sub- and decompensation stage had pronounced anatomical, physiological and morphological changes in the colon; conservative treatment for at least 6 months was ineffective. In these cases, taking into account the duration of constipation and other factors, surgical interventions of varying scope and nature were performed.
In the long-term period after conservative treatment, good results were achieved in 11 cases (73.3%), satisfactory results were observed in 4 cases (26.7%), and there were no unsatisfactory results. In turn, after surgical intervention, good results were recorded in 92 cases (76.0%), satisfactory — in 18 cases (14.9%), however, in 11 cases (9.1%) unsatisfactory results were observed, among which developed recurrence of colostasis.
Conclusion. Thus, the choice of treatment method in patients with chronic coronary syndrome, whether a conservative or surgical approach, is determined strictly individually. It depends on the cause of the disease, its stage and duration of constipation, the severity of anatomical, physiological and morphological changes in the colon, as well as the presence of complications caused by constipation.
Keywords: chronic cologenic stasis, stages and causes of constipation, conservative treatment, resection of the sigmoid colon, hemicolectomy, sub- and total colectomy.
References
1. Anishchenko VV, Kim DA. Subtotal colectomy in patients with chronic colostasis on the background of dolichocolon. Endoscopic surgery. 2020; 26(6): 12-16. (In Russ.)
2. Gulov MK, Nurzoda ZM, Ruziboyzoda KR, Alizadeh SG, Safarov BI. Some issues of classification and etiopathogenesis of chronic gastrointestinal stasis. Healthcare of Tajikistan. 2023; 4: 117-125. (In Russ.)
3. Rakhmanov ST, Navruzov BS. Results of surgical treatment of chronic colonic stasis. Coloproctology. 2014; 3(49): 96-97. (In Russ.)
4. Aliev SA, Aliev ES. Modern trends in the strategy and tactics of surgical treatment of chronic colostasis. Bulletin of Surgery. I.I. Grekov. 2018; 177(2): 95-99. (In Russ.)
5. Dudekula A, Huftless S, Bielefeldt K. Colectomy for constipation: time trends and impact based on the US Nationwide Inpatient Sample, 1998–2011. Aliment Pharmacol Ther. 2015; 42(11-12): 1281-93.
6. Sakulin KA, Karpukhin OYu. Treatment and diagnostic algorithm for resistant forms of cologne constipation in adults. Bulletin of modern clinical medicine. 2021; 14(3): 38-43. (In Russ.)
7. Aliev SA, Aliev ES. Modern trends in the strategy and tactics of surgical treatment of chronic colostasis. Bulletin of Surgery. I.I. Grekov. 2018; 177(2): 95-99. (In Russ.)
8. Ivashkin VT, Maev IV, Sheptulin AA, Trukhmanov AS. Clinical guidelines of the Russian gastroenterological association for the diagnosis and treatment of adult patients with chronic constipation. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2017; 27(3): 75-83. (In Russ.)
9. Reshef A, Alves-Ferreira P, Zutshi M, Hull T, Gurland B. Colectomy for slow transit constipation: effective for patients with coexistent obstructed defecation. Int J Colorectal Dis. 2013; 28(6): 841-847.
10. Mirzakhmedov MM, Kholov HA, Matberdiev YB. Modern tactics of surgical treatment of chronic colostasis. Eurasian journal of medical and natural sciences. 2022; 2(6): 340-350. (In Russ.)
11. Potemin SN. Chronic slowly transient colonostasis: mechanisms of development and possibilities of surgical treatment. Scientific review. Medical Sciences. 2016; 6: 84-103. (In Russ.)
12. Vergara-Fernandez O, Mejia-Ovalle R, Salgado Nesme N, Rodriguez-Dennen N, et al. Functional outcomes and quality of life in patients treated with laparoscopic total colectomy for colonic inertia. Surg Today. 2014; 44(1): 34-38.
