<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">zdor</journal-id><journal-title-group><journal-title xml:lang="ru">Проблемы здоровья и экологии</journal-title><trans-title-group xml:lang="en"><trans-title>Health and Ecology Issues</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2220-0967</issn><issn pub-type="epub">2708-6011</issn><publisher><publisher-name>Gomel State Medical University</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.51523/2708-6011.2023-20-4-05</article-id><article-id custom-type="elpub" pub-id-type="custom">zdor-2644</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКАЯ МЕДИЦИНА</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL MEDICINE</subject></subj-group></article-categories><title-group><article-title>Усовершенствованный метод гемостаза для средней прямокишечной артерии</article-title><trans-title-group xml:lang="en"><trans-title>Improved method of hemostasis for the middle rectal artery</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0116-7481</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кузьменко</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kuzmenko</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кузьменко Александр Викторович, к.м.н., доцент, доцент кафедры анатомии человека с курсом оперативной хирургии и топографической анатомии</p><p>Гомель</p></bio><bio xml:lang="en"><p>Alexander V. Kuzmenko, Candidate of Medical Scienc- es, Associate Professor at the Department of Human Anatomy with the course of Operative Surgery and Topographic Anatomy</p><p> Gomel</p></bio><email xlink:type="simple">alexxx3800@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3537-2803</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Жданович</surname><given-names>В. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Zhdanovich</surname><given-names>V. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Жданович Виталий Николаевич, к.м.н., доцент, заведующий кафедрой анатомии человека с курсом оперативной хирургии и топографической анатомии</p><p>Гомель</p></bio><bio xml:lang="en"><p>Vitaly N. Zhdanovich, Candidate of Medical Sciences, Associate Professor, Head of the Department of Human Anatomy with the course of Operative Surgery and Topographic Anatomy</p><p>Gomel</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Гомельский государственный медицинский университет</institution></aff><aff xml:lang="en"><institution>Gomel State Medical University</institution></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>04</day><month>01</month><year>2024</year></pub-date><volume>20</volume><issue>4</issue><elocation-id>45–50</elocation-id><permissions><copyright-statement>Copyright &amp;#x00A9; Кузьменко А.В., Жданович В.Н., 2024</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="ru">Кузьменко А.В., Жданович В.Н.</copyright-holder><copyright-holder xml:lang="en">Kuzmenko A.V., Zhdanovich V.N.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://journal.gsmu.by/jour/article/view/2644">https://journal.gsmu.by/jour/article/view/2644</self-uri><abstract><p>Цель исследования. Получить данные по сравнительной характеристике традиционного и усовершенствованного методов гемостаза для средней прямокишечной артерии (СрПА).Материалы и методы. Материалом для секционного исследования послужили 206 трупов мужчин (возраст умерших — от 22 до 82 лет, средний возраст — 57 лет) и 113 трупов женщин (возраст умерших — от 32 до 93 лет, средний возраст — 63 года). Для достижения цели исследования применялись следующие методы: инъекция сосудов, препарирование, статистическая обработка.Для проведения клинической части исследования в учреждении «Гомельская областная специализированная клиническая больница» были отобраны 85 пациентов обоего пола в возрасте от 57 до 75 лет. Среди них 50 человек входили в группу сравнения и 35 человек — в основную группу. У всех заболевших был диагностирован рак прямой кишки I или II стадии. Оперативный прием для проведения гемостаза на СрПА при выполнении передней резекции прямой кишки в группе сравнения включал последовательное лигирование и прошивание между зажимами сначала дистальной трети длины этой артерии, а затем ее проксимальной трети. В основной группе метод проведения гемостаза для СрПА дополнялся лигированием и прошиванием этого сосуда в средней трети его длины. Статистическая обработка данных включала параметрические и непараметрические методы сравнительного анализа.Результаты. На трупном материале установлено, что большая часть внеорганных анастомозов СрПА у мужчин и женщин локализуется в средней трети этой артерии. Полученные в ходе клинического исследования результаты демонстрируют превосходство усовершенствованного метода гемостаза для СрПА над традиционным методом. Предложенный метод включает дополнительное лигирование и прошивание средней трети СрПА. Заключение. Усовершенствованный метод гемостаза для СрПА при передней резекции прямой кишки является высокоэффективным, что позволяет рекомендовать его в качестве метода выбора при хирургическом лечении верхнеампулярного рака прямой кишки I или II стадии. </p></abstract><trans-abstract xml:lang="en"><p>Objective. To obtain data on the comparative characteristics of traditional and improved methods of hemostasis for the middle rectal artery (MRA).Materials and methods. The material for the sectional study was 206 corpses of men (the age of the deceased was from 22 to 82 years, the average age was 57 years) and 113 corpses of women (the age of the deceased was from 32 to 93 years, the average age was 63 years). To achieve the purpose of the study, the following methods were used: vascular injection, dissection, statistical processing. 85 patients of both sexes aged from 57 to 75 years were selected to conduct the clinical part of the study at Gomel Regional Specialized Clinical Hospital. Among them, 50 people were in the comparison group and 35 people were in the main group. All patients were diagnosed with stage I or II rectal cancer. The operative technique for performing hemostasis on the MRA during anterior rectal resection in the comparison group included sequential ligation and stitching between the clamps first of the distal third of the length of this artery, and then its proximal third. In the main group, the method of hemostasis for MRA was supplemented by ligation and stitching of this vessel in the middle third of its length. Statistical data processing included parametric and nonparametric methods of comparative analysis.Results. On cadaveric material, it was found that most of the extraorgan anastomoses of the MRA both in men and women have been localized in the middle third of this artery. The results obtained during the clinical study demonstrate the superiority of the improved hemostasis method for MRA over the traditional method. The proposed method includes additional ligation and stitching of the middle third of the MRA.Conclusion. The improved hemostasis method for MRA in anterior rectal resection is highly effective, which makes it possible to recommend it as the method of choice in the surgical treatment of upper ampullary rectal cancer of stage I or II. </p></trans-abstract><kwd-group xml:lang="ru"><kwd>средняя прямокишечная артерия</kwd><kwd>внеорганные анастомозы</kwd><kwd>полость таза</kwd></kwd-group><kwd-group xml:lang="en"><kwd>middle rectal artery</kwd><kwd>extraorgan anastomoses</kwd><kwd>pelvic cavity</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Schneider EB, Hyder O, Brooke B, Efrom J, Cameron J, Edil B, et al. Patient readmission and mortality and colorectal surgery for colon cancer: impact of length of stay relative to other clinical factors. J Am Coll Surg. 2012;214(4):390-299. DOI: https://doi.org/10.1016/j.jamcollsurg.2011.12.025</mixed-citation><mixed-citation xml:lang="en">Schneider EB, Hyder O, Brooke B, Efrom J, Cameron J, Edil B, et al. Patient readmission and mortality and colorectal surgery for colon cancer: impact of length of stay relative to other clinical factors. J Am Coll Surg. 2012;214(4):390-299. DOI: https://doi.org/10.1016/j.jamcollsurg.2011.12.025</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Climent M, Martin SM. Complications of laparascopic rectal cancer surgery. Mini-invasive Surg. 2018;2:45. DOI: http://doi.org/10.20517/2574-1225.2018.62</mixed-citation><mixed-citation xml:lang="en">Climent M, Martin SM. Complications of laparascopic rectal cancer surgery. Mini-invasive Surg. 2018;2:45. DOI: http://doi.org/10.20517/2574-1225.2018.62</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Varela C, Nassr M, Kim NK. Exposure of the middle rectal artery and lateral ligament of the rectum following the gate approach during total mesorectal excision. Yonsei Med J. 2022;63(5):490-492. DOI: http://doi.org/10.3349/ymj.2022.63.5.490</mixed-citation><mixed-citation xml:lang="en">Varela C, Nassr M, Kim NK. Exposure of the middle rectal artery and lateral ligament of the rectum following the gate approach during total mesorectal excision. Yonsei Med J. 2022;63(5):490-492. DOI: http://doi.org/10.3349/ymj.2022.63.5.490</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Sonje PD, Kanasker NS, Vatsalaswamy P. Surgical importance of middle rectal artery. NJCA. 2019;8(4):165-168. DOI: http://doi.org/10.1055/s-0039-3401901</mixed-citation><mixed-citation xml:lang="en">Sonje PD, Kanasker NS, Vatsalaswamy P. Surgical importance of middle rectal artery. NJCA. 2019;8(4):165-168. DOI: http://doi.org/10.1055/s-0039-3401901</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Hoffer EK. Transcatheter embolization in the treatment of hemorrhage in pelvic trauma. Semin Intervent Radiol. 2008;25(3):281-292. DOI: http://doi.org/10.1055/s-0028-1085928</mixed-citation><mixed-citation xml:lang="en">Hoffer EK. Transcatheter embolization in the treatment of hemorrhage in pelvic trauma. Semin Intervent Radiol. 2008;25(3):281-292. DOI: http://doi.org/10.1055/s-0028-1085928</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Niekamp A, Sheth RA, Kuban J, Avritscher R, Ganguli S. Palliative embolization for refractory bleeding. Semin Intervent Radiol. 2017;34(4):387-397. DOI: http://doi.org/10.1055/s-0037-1608862</mixed-citation><mixed-citation xml:lang="en">Niekamp A, Sheth RA, Kuban J, Avritscher R, Ganguli S. Palliative embolization for refractory bleeding. Semin Intervent Radiol. 2017;34(4):387-397. DOI: http://doi.org/10.1055/s-0037-1608862</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Burdick TS, Hoffer EK, Kooy T, Ghodke B, Stames BW, Valji K. Which arteries are expendable? The practice and pitfalls of embolization throughout the body. Semin Intervent Radiol. 2008;25(3):191-203. DOI: http://doi.org/10.1055/s-0028-1085925</mixed-citation><mixed-citation xml:lang="en">Burdick TS, Hoffer EK, Kooy T, Ghodke B, Stames BW, Valji K. Which arteries are expendable? The practice and pitfalls of embolization throughout the body. Semin Intervent Radiol. 2008;25(3):191-203. DOI: http://doi.org/10.1055/s-0028-1085925</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Singh A, Kumar A, Kumar P, Kumar S, Gamanagatti S. “Beyond saving lives”: current perspectives of interventional radiology in trauma. World J Radiol. 2017;9(4):155-177. DOI: http://doi.org/10.4329/wjr.v9.i4.155</mixed-citation><mixed-citation xml:lang="en">Singh A, Kumar A, Kumar P, Kumar S, Gamanagatti S. “Beyond saving lives”: current perspectives of interventional radiology in trauma. World J Radiol. 2017;9(4):155-177. DOI: http://doi.org/10.4329/wjr.v9.i4.155</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Минеев КП. Клинико-морфологические аспекты перевязки сосудов таза. Свердловск, РФ: Изд. Урал. ун-та; 1990.</mixed-citation><mixed-citation xml:lang="en">Mineev KP. Clinical and morphological aspects of pelvic vessels ligation. Sverdlovsk, RF: Edd. Ural. unirvers; 1990. (In Russ.).</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Кузьменко АВ. Хирургическая анатомия внеорганных анастомозов средней прямокишечной артерии. Проблемы Здоровья и Экологии. 2020;63(1):34-39. DOI: https://doi.org/10.51523/2708-6011.2020-17-1-6</mixed-citation><mixed-citation xml:lang="en">Kuzmenko A.V. Surgical anatomy of the extraorgan anastomoses of the middle rectal artery. Health and Ecology Issues. 2020;63(1):34-39. (In Russ.). DOI: https://doi.org/10.51523/2708-6011.2020-17-1-6</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
