Risk factors for colon adenomas recurrence after endoscopic mucosal resection

Ваганов, Ю. Е.; Веселов, В. В.; Likutov, A. A.; Хомяков, Е. А.; Чернышов, С. В.; Абдулжалиева, Э. У.; Ачкасов, С. И.

doi:10.33878/2073-7556-2021-20-1-10-16

Cited by 17 publications

(2 citation statements)

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“…Классическая эндоскопическая резекция слизистой оболочки (endoscopic mucosal resection, EMR) -это простой и эффективный метод, широко используемый во всем мире при лечении больных с эпителиальными новообразованиями толстой кишки [1]. Однако при удалении опухолей размером более 20 мм методом EMR частота резекции единым блоком прогрессивно снижается, нередко по причине фрагментации опухоли, которая, в конечном счете, негативно отражается на частоте локальных рецидивов [2,3]. Исходя из основного принципа радикального эндоскопического вмешательства, который подразумевает удаление опухоли единым блоком с достижением негативных границ резекции (R0), эндоскопическая диссекция в подслизистом слое все чаще используется для преодоления недостатков мукозэктомии.…”

Section: Introductionunclassified

“…Примечание: р* -точный критерий Фишера; р** -критерий Манна-Уитни; р*** -критерий χ2 Эндоскопическая мукозэктомия с циркулярным разрезом слизистой оболочки в лечении опухолей ободочной кишки. Результаты рандомизированного исследования.Endoscopic mucosal resection with a circumferential incision in the removal of colon neoplasms.…”

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Endoscopic mucosal resection with a circumferential incision in the removal of colon neoplasms. Results of a randomized trial.

Abdulzhalieva,

Likutov,

Veselov

et al. 2024

Koloproktologiâ

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OBJECTIVE: to compare the immediate and long-term results of endoscopic mucosal resection with a circular incision (C-EMR) and endoscopic submucosal dissection (ESD) in the treatment of patients with large benign epithelial neoplasms of the colon.PATIENTS AND METHODS: a prospective randomized comparative study was conducted from November 2020 to July 2022, included 103 patients with benign epithelial neoplasms of the colon ranging in size from 20 to 30 mm. The C-EMR method was used in 52, ESD - 51 patients.RESULTS: the removal of the tumor by the C-EMR method required statistically significantly less time, compared with the ESD method – 30 and 60 minutes, respectively (p<0.001). Intra- and postoperative complications occurred in 13(23.7%) patients in the C-EMR group and in 12(23.5%) patients in the ESD group. The most frequently reported complication was postcoagulation syndrome in the main and control groups – in 9(17.3%) and 11(21.6%) cases, respectively. It was found that the difficult location of the tumor (OR=18.3; p=0.01) and intraoperative complications (OR =37.5; p=0.04) are independent conversion factors of endoscopic intervention. The frequency of tumor removal in a en bloc and achievement of negative resection margins (R0) in the main and control groups did not significantly differ – 47(90.4%) and 49(96.1%) (p=0.4) and 40(76.9%) and 45(88.2%) (p=0.2), respectively.CONCLUSION: endoscopic mucosal resection with a circumferential incision is an effective and safe operation comparable to endoscopic submucosal dissection, and can be the method of choice for benign epithelial neoplasms of the colon with sizes from 20 to 30 mm. In addition, the duration of the operation using the C-EMR method is two times less than using ESD.

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Section: Introductionunclassified

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Endoscopic mucosal resection with a circumferential incision in the removal of colon neoplasms. Results of a randomized trial.

Abdulzhalieva,

Likutov,

Veselov

et al. 2024

Koloproktologiâ

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Modifiable factors of development and recurrence of adenomatous colorectal polyps (literature review)

Gataullin,

Sakhabetdinov,

Valitov

et al. 2024

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Relevance. Adenomatous colorectal polyps are associated with a high risk of developing a malignant tumor. They are considered precancerous conditions and can lead to the development of colorectal cancer. To date, colorectal cancer ranks third in the world in frequency of occurrence among all malignant neoplasms.Objective. Improving the results of diagnosis and surgical treatment of patients with colorectal adenomatous neoplasms by identifying development factors and identifying risk groups for this nosology.Materials and methods. Analysis of literary data.Results. Among the factors leading to the development of colorectal polyps, it is worth noting a genetic predisposition, so by immunoblotting, PCR sequencing of the entire exome in cases of patients with familial dentate polyposis, rare variants of the germ line in the WNK2 gene were identified. Functional studies have shown that variants of the WINK2 germ line affect protein function in the context of the MAPK pathway, a molecular trait of this disease. Also, in the course of many domestic and foreign randomized clinical trials, the following modifiable factors for the development of adenomatous colorectal polyps were identified.Conclusion. The study revealed the factors of development and recurrence of colorectal neoplasms and identified risk groups for this nosology. The study revealed low compliance of patients with respect to changes in certain living conditions (the use of ethyl alcohol and products containing it, tobacco smoking, both active and passive, the fight against obesity and inactivity), which leads to recurrence and increases the risks of malignancy of colorectal polyps.

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Management of a Female Patient with Irritable Bowel Syndrome and Somatoform Disorder

Trush

Полуэктова

Бениашвили

et al. 2023

Rossijskij žurnal gastroènterologii, gepatologii, koloproktolog

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Aim: to demonstrate the management of a patient with somatization disorder and irritable bowel syndrome.Key points. A 41-yo female patient was admitted with complains of spastic lower abdomen pain, hard stool once every 1–2 days under laxative treatment (macrogol), bloating, anxiety, waiting for confirmation of a life threatening illness, internal stress, difficulty in falling asleep, shallow sleep. Has a long history of disease, characterized by the appearance of a variety of somatic symptoms (headache, tachycardia, joint pain, stool disorders, abdominal pain, etc.) during periods of emotional tension, lack of data suggesting organic disease. No abnormal changes were detected in examination at the clinic (complete blood count, serum chemistry tests, urinalysis or fecal tests, hydrogen and methane breath tests with lactulose, abdominal ultrasound, esophagogastroduodenoscopy, colonoscopy). With the prior agreement of patient, she was consulted by a psychiatrist and diagnosed with somatization disorder and mild anxiety disorder. On discharge from hospital recommended cognitive-behavioral therapy, continue taking macrogol, as well as treatment with Kolofort. After 3 months of complex treatment, there was a significant decrease in the severity of both the symptoms of irritable bowel syndrome and anxiety disorder.Conclusion. For patients whose complaints meet the diagnostic criteria for IBS, a two-stage differential diagnosis may be justified: at the first stage, differentiation of IBS and organic diseases of the gastrointestinal tract is carried out; at the second stage - IBS and somatization disorder. Kolofort can be the drug of choice both in patients with IBS and the pharmacological part of therapy in patients with somatization disorder.

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Risk factors for colon adenomas recurrence after endoscopic mucosal resection

Cited by 17 publications

References 19 publications

Endoscopic mucosal resection with a circumferential incision in the removal of colon neoplasms. Results of a randomized trial.

Endoscopic mucosal resection with a circumferential incision in the removal of colon neoplasms. Results of a randomized trial.

Modifiable factors of development and recurrence of adenomatous colorectal polyps (literature review)

Management of a Female Patient with Irritable Bowel Syndrome and Somatoform Disorder

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