Цель. Сравнительное изучение эффективности открытой и лапароскопической вентральной сетчатой сакрокольпоректопексии и сакроректопексии (у мужчин) при выпадении органов таза. Материалы и методы. В Учебно-хирургической клинике Азмедуниверситета (2012-2021 гг.) и на медицинском факультете Университета Анкары (Турецкая Республика) (2016-2020 гг.) было проведено хирургическое лечение выпадения органов таза, в том числе прямой кишки (ПК) и матки, абдоминальными доступами 46 пациентам, среди которых 21 пациенту была произведена лапароскопическая вентральная сетчатая сакрокольпоректопексия (ЛВСКРП) (15 женщин) и сакроректопексия (ЛВСРП) у 6 мужчин. Открытые аналогичные операции были проведены 25 пациентам (18 женщин, 7 мужчин). Средний возраст пациентов в лапароскопической группе составлял 49,0±2,3 года (от 31 года до 65 лет), в открытой - 52,5±2,7 (от 33 до 65 лет). Результаты. В основном рецидивы выпадения матки (1) и влагалища (1) после лапаротомной операции встречались у женщин в постменопаузе. Этим пациентам была выполнена соответственно вагинальная гистерэктомия и экстирпация культи шейки матки с открытой сакровагинопексией и кольполеваторопластикой с хорошими отдаленными результатами. Рецидивы после ЛВСР не развивались. Летальных исходов не было. Выводы. Результаты исследования показали, что при пролапсе более одного органа таза у пожилых пациенток возможно одномоментное выполнение фиксации матки или культи влагалища и ПК лапароскопическим и лапаротомным доступами с последующим выполнением леваторопластики или кольполеваторорафии и ректопексии. Оценка отдаленных результатов хирургического лечения в течение 6-12 мес. не выявила высокой частоты рецидивов пролапса и хирургических осложнений, требующих повторных операций. Purpose. Comparative study of the effectiveness of open and laparoscopic ventral sacrocolporectopexy and sacrorectopexy (in men) in the fall of pure organs. Materials and methods. In the Teaching and Surgical Clinic of Azerbaijan Medical University (2012- 2021) and the Medical Faculty of the University of Ankara (Turkish Republic) (2016-2020) surgical treatment of pelvic organ failure was performed, including rectum and uterus with abdominal access in 46 patients, among the last 21 patients (15 women) was performed laparoscopic ventral sacrocolporectopexy (sacrorectopexy). Open analog surgeries were performed on 25 patients (18 women, 7 men). The mean age of patients in the laparoscopic group was 49.0±2.3 (from 31 to 65), in the open - 52.5±2.7 (from 33 to 65). Results. In the main relapses of ejaculation of the uterus (1) and vagina (1) after laparotomy surgery were encountered in postmenopausal women. These patients were performed accordingly, vaginal hysterectomy and extirpation of the cervix cultures with open sacrovaginopexia and colpolevatoroplasty with good long-term results. Recurrences after the laparoscopic ventral sacrocolporectopexy did not develop. There were no lethal outbreaks. Conclusions. The results of the study showed that in the case of prolapse of more than one organ in elderly patients, it is possible to perform instant fixation of the uterus or cult of the vagina and PC with laparoscopic and laparotomy procedures with follow-up. Evaluation of the results of surgical treatment in the course of 6-12 months did not reveal a high frequency of recurrences of prolapse and surgical complications requiring repeated operations.

Purpose: The work was aimed at comparative studying of the functional and physical state of the patients with rectal prolapse after surgical treatment with various surgical techniques and at identifying the most optimal procedure technique.Patients and methods: The authors observed 49 patients (32 women, or 65.3 %) aged 22 — 83 years (the median age of women was 46.1 ± 1.3 years old, of men — 48.7 ± 1.4 years old) with the rectal prolapse of varying severity. The Delorme’s procedure was indicated for 28 patients (57.1 %). Perianal proctosigmoidectomy (the Altemeier’s surgery) was performed in 12 patients (24.5 %). In the young patients, preference was given to the Ripstein’s abdominal surgery (nine patients; 18.4 %). To objectively assess the physical state of the anal sphincter apparatus, traditional sphincterometry was performed using S4402 sphincterometer with a nonperfusing sensor (Pro Medika GmbH, Germany), and the functional state of the sphincter complex was subjectively assessed using the Wexner’s score scale.Results: The best results were obtained after the Delorme’s procedure (p<0.05), while the worse results were obtained in the young patients after the Ripstein’s surgery (p<0.05).Conclusion: The obtained results may be used for assessing the functional and physical state of the anal sphincter complex in the surgical treatment of the patients with the rectal prolapse syndrome, especially in those with ASFs of varying severity.

Objective. To improve the results of diagnosis and surgical treatment of rectal mucosa prolapse, complicated by the anal sphincter insufficiency. Materials and methods. Analysis of the diagnosis and surgical treatment results in the rectal mucosa prolapse with the anal sphincter insufficiency was done in 23 patients, ageing 31 - 65 yrs old and the age median (41.5 ± 1.8) yrs old, of them 17 women-patients. Results. There was revealed, that most frequently and in mostly progressive forms the rectal mucosa prolapse with the anal sphincter insufficiency occurs in women, aged more than 36 yrs old. Conclusion. Miniinvasive transanal operations, submucosal injection procedures and sphincteroplasty “end-to-end” were used predominantly, owing less morbidity potency (26.1%), favorable remote functional results - the recurrence rate lowering (4.3%), the fecal incontinence degree lowering (78.6%), and the patients’ quality of life improvement.

The article presents a comparative study of the results of surgical treatment with abdominal and perineal approaches in patients with rectal prolapse. In 83 patients of both sexes (52 women) aged 16-85 years (median in women 46.5 ± 1.1, in men 48.2 ± 1.7 years) with rectal prolapse, abdominal or perineal fixation surgeries with and without resection of the prolapsed part of the rectum and minimally invasive surgeries were performed. After the abdominal or perineal procedures, including minimally invasive procedures, stable and successful results were obtained in 80 patients (96.4%). Recurrences occurred only in 2 cases, and mortality in 1 case. Local complications developed in the form of wound infection (6), and feeling of a foreign body during mesh rectopexy (3); general complications included sepsis (1) and constipation (3). No major complications were requiring repeated surgery. In rectal prolapse surgery, abdominal procedures are ideal for young patients, and perineal procedures are ideal for elderly and senile patients with severe concomitant pathology. Suture rectopexy is characterized by adequate treatment, while mesh rectopexy is not superior to suture rectopexy. However, meshes as a foreign body increase the risk of local infection. Both rectopexy options are popular with many surgeons and the choice depends on the experience and preference of the surgeon. Laparoscopic rectopexy has results that are equivalent to or better than open pexy. It is preferred because it is simple and easy to perform. The results of perianal rectosigmoidectomy are much better than Delorme procedures, especially when the posterior levatoroplasty is added to it.