nogrЭкспериментальная и клиническая гастроэнтерологияExperimental and Clinical Gastroenterology1682-8658«Global Media Technologies»10.31146/1682-8658-ecg-179-7-163-166nogr-1411Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL CASESКоррекция полной облитерации просвета толстокишечного анастомоза формированием под EUS контролем ректосигмоидального соустья и стентированием нитиноловым саморасправляющимся стентомEUS-guided recovery of colonic continuity after complete anastomotic stenosis with a nitinol self-expanding stentСолоницынЕ. Г.SolonitsynE. G.

Солоницын Евгений Геннадьевич - кандидат медицинских наук, заведующий отделения эндоскопии.Санкт-Петербург, ул. Аккуратова, д. 2 197341.Scopus ID: 26435567100

Evgeny G. Solonitsyn - candidate of medical sciences head of endoscopy department.2, Akkuratova str., Saint Petersburg, 197341.

ДаниловИ. Н.DanilovI. N.

Данилов Иван Николаевич - кандидат медицинских наук, заведующий отделения хирургических методов лечения онкологических больных.Санкт-Петербург, ул. Аккуратова, д. 2 197341.

Ivan N. Danilov - Ph. D. Head of the Department of Surgical Cancer Treatment.2, Akkuratova str., Saint Petersburg, 197341.

КиреевШ. У.KireevSh. U.

Киреев Шамиль Уралович - врач-эндоскопист, отделение эндоскопии.Санкт-Петербург, ул. Аккуратова, д. 2 197341.

Shamil U. Kireev - endoscopist, endoscopy department.2, Akkuratova str., Saint Petersburg, 197341.

kireevmd@yandex.ruКовалёвА. А.KovalevA. A.

Ковалёв Александр Андреевич - врач-хирург, отделение хирургических методов лечения онкологических больных.Санкт-Петербург, ул. Аккуратова, д. 2 197341.

Alexander A. Kovalev - surgeon, department of surgical methods for treating cancer patients.2, Akkuratova str., Saint Petersburg, 197341.

НМИЦ им. В.А. АлмазоваРоссияAlmazov NMRCRussian Federation20202709202007163166Copyright © Солоницын Е.Г., Данилов И.Н., Киреев Ш.У., Ковалёв А.А., 20202020Солоницын Е.Г., Данилов И.Н., Киреев Ш.У., Ковалёв А.А.Solonitsyn E.G., Danilov I.N., Kireev S.U., Kovalev A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nogr.org/jour/article/view/1411

Реконструктивные операции на толстой кишке остаются сложной хирургической проблемой. Предшествующие оперативные вмешательства зачастую проводятся в экстренном порядке, на фоне перитонита, ишемических и некротических изменений кишки. Следствием этого является выраженный спаечный процесс в брюшной полости, измененная анатомия и трудности в распознавании анатомических структур.В статье описывается клинический случай эндоскопического восстановления непрерывности толстой кишки у пациента со стриктурой толстокишечного анастомоза с полной облитерацией просвета. Пациенту была выполнена операция «Формирование ректосигмоидального соустья под EUS контролем. Стентирование стриктуры нитиноловым полностью покрытым саморасправляющимся стентом.С целью формирования стабильного соустья в течение 6 месяцев было проведено 4 сеанса баллонной дилатации и 1 сеанс бужирования. В настоящее время диаметр толстой кишки на уровне стриктуры около 14 мм, клинически стриктура не значима.Энтеростомия под ЭУС наведением может быть использована для формирования межкишечного соустья у пациентов с доброкачественными заболеваниями. Однако данный метод сам по себе не является окончательным способом лечения и требует дальнейшей курации пациентов.

Recovery of intestinal continuity is remaining a complex issue in abdominal surgery. Previous operations, such as Hartmann's procedure, are usually done in the emergent setting, often in frail and septic patients. As a result, severe adhesions occur, and recognition of various anatomical structures becomes more difficult.The article describes a clinical case of EUS-guided recovery of rectum's continuity after complete anastomotic stenosis. The operation “EUS-guided formation of rectosigmoid anastomosis using Lumen-Apposing Metal Stent” was performed.In order to obtain a stable anastomosis within 6 months, a session of bougienage and 4 sessions of balloon dilatation were performed. Currently, the diameter of the colon at the stricture level is about 14 mm, clinically stricture is not significant.EUS-guided enterostomy can be used to form an intestinal anastomosis in patients with benign diseases. However, this method alone is not the final method of treatment and requires further supervision of patients.

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