DOI: https://doi.org/10.22263/2312-4156.2025.2.39
K.G. Tsyplakov1, V.L. Denisenko1,2, Yu.M. Gain3, V.A. Prischepenko2, A.O. Semenova1
Efficiency assessment of a complex minimally invasive method of surgical rehabilitation in patients with artificial colostomies
1Vitebsk Regional Clinical Specialized Center, Vitebsk, Republic of Belarus
2Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
3Belarusian State Medical University, Minsk, Republic of Belarus
Vestnik VGMU. 2025;24(2):39-48.
Abstract.
Objectives. To evaluate medical, social and economic efficiency of the new complex minimally invasive method of surgical rehabilitation in patients with artificial colostomies.
Material and methods. The treatment results of 103 patients with artificial colostomies (2016 to 2024) were analyzed within the framework of a prospective dynamic study. Patients were randomized into two study groups. In the main group (n=53), a complex minimally invasive method of surgical rehabilitation of patients with colostomies was used, including laparoscopically assisted surgery based on the principles of ERAS, accompanied by an increase in the biological tightness of the colonic anastomosis by using fibrin glue ‘‘Fibrinostat’’. In the control group (n=50), stoma closure was performed by traditional laparotomy.
Results. Patients in both groups were homogeneous by gender, social status, age, BMI, stoma wearing time, ASA scale (p˃0.05). The surgery duration in the main group was 190 (160-235) min, in the control group – 240 (200-275) min (Z=-3.21, p=0.0018). The volume of blood loss in the main group averaged 50 (30-100) ml, in the control group – 165 (120-290) (Z=-6.66, p<0.00001). Patients in the control group spent 1.75 times more time in the ICU (Z=-5.05, p<0.00001). The postoperative period in the main group was significantly shorter (Z=-6.29, p<0.00001). Bowel function based on the principle of stool passage (Z=-4.28, p=0.00003) and gas (Z=-2.3, p=0.026) was restored faster in the main group. Positive clinical data correlated with the complete implementation of ERAS principles. Data on greater safety, medical, social and economic efficiency of treatment of patients in the main group were also obtained.
Conclusions. The use of a complex minimally invasive method of surgical rehabilitation in patients with artificial colostomies allows obtaining a significant medical and social effect, as well as significant savings in the funds spent on treatment.
Keywords: colostomy closure, reconstructive bowel surgery, laparoscopic colorectal surgery, results of surgical treatment.
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Submitted 03.03.2025
Accepted 14.04.2025
Information about authors:
Konstantin G. Tsyplakov – head of the proctology department of the Vitebsk Regional Clinical Specialized Center, e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра.;
V.L. Denisenko – Doctor of Medical Sciences, Professor, Chief Physician of the Vitebsk Regional Clinical Specialized Center; Professor of the Chair of General Surgery, Vitebsk State Order of Peoples’ Friendship Medical University;
Yu.M. Gain – Honored Scientist of the Republic of Belarus, Doctor of Medical Sciences, Professor of the Chair of Military Field Surgery, Belarusian State Medical University;
V.A. Prischepenko – Candidate of Medical Sciences, Associate Professor of the Chair of Propaedeutics of Internal Diseases, Vitebsk State Order of Peoples’ Friendship Medical University;
A.O. Semenova – proctologist at the stoma care office, Vitebsk Regional Clinical Specialized Center.
