Coloproctology and Endoscopic Surgery in Uzbekistan

INDICATIONS FOR SURGICAL TREATMENT OF INFLAMMATORY AND ULCERATIVE DISEASES OF THE COLON

M Akhmedov — 2023-04-15

Indications for surgical treatment at inflammatory-ulcerative colitis (UC, Crohn's disease) are: severe (massive) bleeding, colonic perforation, colonic stricture, pseudopolyposis, ulcer malignization, resistance to conservative therapy (hormone-resistant forms of ulcerative colitis), disease progressing, development of extraintestinal complications combined with intestinal complications.

Differential approach to the choice of surgical treatment tactics is recommended; indications for total colectomy with overlaying of various anastomoses with preventive ileostomy for prevention of postoperative complications are determined.

SURGICAL TACTICS FOR EXTERNAL AND INTERNAL SMALL AND LARGE INTESTINAL FISTULAS

М.А. Akhmedov — 2023-04-15

Improvement of the results of surgical treatment of small and large intestinal fistulas by improving diagnosis and introducing new surgical techniques.

THE USE OF IMAGING INTRAOPERATIVE PHOTOPLETHYSMOGRAPHY AND ICG-FLUORESCENCE IN PATIENTS WITH COLORECTAL CANCER

V.V. Davletshina — 2023-04-15

The possibilities of imaging photoplethysmography and ICG fluorescent angiography as intraoperative methods of tissue perfusion assessment are demonstrated. What is the most frequent reason for such a serious postoperative complication as anastomosis incompetence. The basic concepts for understanding the process of imaging photoplethysmography are described. The revealed data show that the development of non-invasive intraoperative methods of visualization of blood supply to the anastomosed intestinal sections is dynamically developing and requires further investigation.

THE USE OF MINIMALLY INVASIVE METHODS OF TREATMENT IN ACUTE INTESTINAL OBSTRUCTION COMPLICATED BY PERITONITIS

Sh.N. Kadirov — 2023-04-15

The adhesive intestinal obstruction complicated by peritonitis is a rather widespread and severe disease demanding urgent operative interventions and the death rate comes to 9,6 - 65,7%. Proceeding from these facts the aim to reduce the risk of the disease relapse, to increase prevention level of the adhesive intestinal obstruction complicated by peritonitis by means of applying modern methods of treatment is set. Clinical estimation of 71 patients with SCNOS who were treated in our clinic for the last 5 years was carried out in the present research. Relevant conclusions, indicating the following facts were made on the basis of the sufficient clinical material; that treatment by laparoscopic method allows not only to eliminate the cause of the sacral intestinal obstruction complicated by peritonitis, but it is the effective method of prophylaxis of the adhesions after surgical intervention. Furthermore, it is fully compliant with aesthetic and cosmetic surgery requirements. Most importantly, the given method prevents the recurrence of adhesions, and it is especially important for the patients with predisposition to adhesions.

OPTIONS FOR OPTIMIZING NEOADJUVANT THERAPY FOR RECTAL CANCER

А.М. Karachun — 2023-04-15

Preoperative radiotherapy has now become a standard component of combined treatment of locally advanced rectal cancer. However, the search for more effective options for neoadjuvant treatment of the tumor, in the hope of enhancing the severity of its regression and thereby increasing the likelihood of radical treatment, has not ceased. This article is devoted to the review of the techniques of neoadjuvant therapy rationalization of rectal cancer proposed in the modern literature.

OPTIONS FOR OPTIMIZING NEOADJUVANT THERAPY FOR RECTAL CANCER

М.М. Madazimov — 2023-04-15

The subject of the present investigation were 127 patients to whom Hartmann's operation was carried out at non-tumorous diseases of the large intestine (sigmoid colon volvulus - 123; stab wound - 4). According to aim and objectives of our study authors conventionally allocated two groups: control, including 73 (57,5%) patients with left-sided colonic stoma, which were subjected to retrospective analysis and basic, including 54 (42,5%) similar patients, where surgical tactics and technical operations techniques were optimized.

As the result of carried out work the authors significantly improved the results of surgical treatment at RBO after Hartmann operation, that is caused by complex approach, using proposed two-stage therapeutic and diagnostic algorithm, as well as tactical and technical aspects and using perfected invagination and "immersion" invagination anastomoses.

Summarizing, the authors conclude that surgical tactics should be active in terms of diagnostics, preoperative preparation and postoperative management as well as individualized in terms of timing and modes of RVO.

STAGES OF PREPARATION AND EXAMINATION OF RELATED LIVER DONORS AND THEIR PERIOPERATIVE MANAGEMENT

К.О. Semash — 2023-04-15

The selection, preparation, and perioperative management of the intravital liver donors is a complicated and responsible type of medical care, which requires the maximum of doctors' involvement at all stages. This article describes in detail donor selection and preparation for liver resection and the basic principles of donor resection surgery. Postoperative donor management and rehabilitation are also described in detail.

KETONIC SYNDROME AND ITS BALL RATING AFTER BARIATRIC SURGERY

K.U. Sultanov — 2023-04-15

The early postoperative period after bariatric surgery, similarly to the severe course of type 2 diabetes, is accompanied by a sharp decrease of glycogen stores in the liver of ketones formation.

With dramatic weight loss through lipolysis, plasma fatty acid content increases dramatically, and hepatic exposure to fatty acids increases accordingly (1). This leads to an increase in triglyceride synthesis as well as further oxidation of fatty acids to form ketones. As a result, the concentration of ketones can increase significantly. Pathological ketonemia (acetonemia) increases significantly with further imbalance, when the rate of synthesis of ketone bodies exceeds their utilization by peripheral body tissues [2].

We have described this complication as "postoperative bariatric acetonemic syndrome" (PBAS) with clinical and laboratory findings...

EXPERIENCE IN THE TREATMENT OF COLORECTAL CANCER IN THE ARAL SEA REGION

D.Sh. Khodjiev — 2023-04-15

In the structure of oncological morbidity colorectal cancer ranks the fourth in the world and its proportion in the general structure of morbidity is from 2 to 10%. Approximately 600,000 new cases are reported worldwide each year. Despite the fact that colorectal cancer has many symptoms, up to 80% of patients are admitted to the clinic with stages III and IV of the disease, and every third patient among the operated patients is diagnosed with distant metastases, mainly to the liver (80%) and rarely to other organs (lungs, ovaries, bones, and brain).

STUDYING THE SIGNIFICANCE OF THE INTESTINAL LYMPHATIC SYSTEM IN EXPERIMENTALLY CREATED ULCERATIVE COLITIS MODEL FOR THE USE OF LYMPHOTROPIC THERAPY IN THE COMPLEX OF TREATMENT IN THIS PATHOLOGY

Yu.S. Egamov — 2023-04-15

Ишнинг мақсади: экспериментда ярали колит моделини яратиш, унинг фонида ва меъёрий ҳолатда ичак тутқичларида лимфа ҳаракатланиши хусусиятларини ўрганиш орқали операциядан кейинги даврда даволаш натижасини яхшилашга қаратилган эндомезентериал лимфотроп терапиянинг афзаллигини аниқлаш.