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Evaluation of immediate and long-term results of treatment of post-radiation injuries of the rectum

https://doi.org/10.21518/1995-1477-2021-18-1-82-90

Abstract

Introduction. Treatment of post-radiation damage to the rectum is a complex medical problem. The search for new methods of treatment for this category of patients based on modern achievements in regenerative surgery is urgent.
The aim of the study was to evaluate the immediate and long-term results of treatment of post-radiation lesions of the rectum using microfat grafting.
Materials and methods. The study involved 66 patients — women aged 28 to 83 years inclusive with complications of radiation therapy (rectovaginal fistulas, radiation proctitis, radiation ulcers).
Results and discussion. After the treatment, there is a tendency to improve the condition. So, if before the procedure the average sizes of fistulas and ulcers were 1.67 ± 0.54 cm in diameter, then after 3 months these indicators were 1.39 ± 0.54, and after 6 months — 1.1 ± 0.56 cm Complete epithelialization of the defect was observed in all patients. The period for which it was possible to achieve complete epithelialization varies from 6 months to 2 years. On average, to achieve complete epithelialization of post-radiation damage to the rectum, most patients required 3 injections of autologous adipose tissue. Also, all patients showed an improvement in elastometry indices over time. As a result of treatment, there is a tendency to improve the quality of life of patients.
Conclutions. The study allows us to conclude about the effectiveness of the treatment, as well as that in the long term, the treatment will also be effective, the likelihood of relapse is minimal.

About the Authors

Z. I. Teryushkova
City Clinical hospital No. 8
Russian Federation

Zhanna I. Teryushkova, Cand. Sci. (Med.), head of Coloproctology Department

28, Gorky St., Chelyabinsk, 454071



A. V. Vazhenin
South Ural State Medical University; Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine
Russian Federation

Andrey V. Vazhenin, Academician of RAS, Dr. Sci. (Med.), head of  Department of Oncology, x-ray Diagnostics and x-ray Therapy

64, Vorovskiy St., Chelyabinsk, 454092;

Chief Medical Officer

42, Blyukher St., Chelyabinsk, 454087



V. S. Vasilyev
South Ural State Medical University
Russian Federation

Viacheslav S. Vasilyev, Cand. Sci. (Med.), Teaching Assistant of  Department of Plastic Surgery and Cosmetology

64, Vorovskiy St., Chelyabinsk, 454092



S. A. Vasilyev
South Ural State Medical University
Russian Federation

Sergey A. Vasilyev, Dr. Sci. (Med.), Professor, head of Department of Plastic Surgery and Cosmetology

64, Vorovskiy St., Chelyabinsk, 454092



V. M. Timerbulatov
Bashkir State Medical university
Russian Federation

Vil M. Timerbulatov, Corr. Member of RAS, Dr. Sci. (Med.), Professor, head of Department of Surgery with Endoscopy Module Additional Postgraduate Education Institute

3, Lenin St., ufa, 450008



References

1. Burkovskaya V.A. Radiation-induced intestinal injury. Gastroehnterologiya Sankt-Peterburga = Gastroenterology of Saint Petersburg. 2013;(3–4):18–24. (In Russ.) Available at: http://gastroforum.ru/wp-content/uploads/2013/12/18-24-GSP_2013_3-4-4.pdf.

2. Zuk P.A., Zhu M., Mizuno H., Huang J., Futrell J.W., Katz A.J. et al. Multilineage cells from human adipose tissue: implications for cell-based therapies. Tissue Eng. 2001;7(2):211–218. doi: 10.1089/107632701300062859.

3. Sato M., Uchida K., Nakajima H., Miyazaki T., Guerrero A.R., Watanabe S. et al. Direct transplantation of mesenchymal stem cells into the knee joints of hartley strain guinea pigs with spontaneous osteoarthritis. Arthritis Res Ther. 2012;1418(1):R31. doi: 10.1186/ar3735.

4. Belokhvostikova T.S., Vinnik Yu.S. Comparative effectiveness of the use of immunocorrection in patients with chronic osteomyelitis. Meditsinskaya immunologiya = Medical Immunology (Russia). 2015;17(S):327. (In Russ.) Available at: https://elibrary.ru/item.asp?id=24499361.

5. Alekseeva I.S., Volkov A.V., Kulakov A.A., Goldshteyn D.V. Clinical and experimental substantiation of the use of a combined cell graft based on multipotent mesenchymal stromal cells of adipose tissue in patients with severe deficiency of jaw bone tissue. Geny i Kletki = Genes and Cells. 2012;718(1):97–105. (In Russ.) Available at: https://genescells.ru/article/kliniko-eksperimentalnoe-obosnovanie-ispolzovaniyakombinirovannogo-kletochnogo-transplantata-na-osnovemultipotentnyih-mezenhimnyih-stromalnyih-kletok-zhirovoytkani-u-patsientov-s-vyirazhennyim-def.

6. Berezniakov I.G., Korzh I.V. Immunological and biochemical disorders at osteoarthritis in combination with hypertension and obesity. Mezhdunarodnyy meditsinskiy zhurnal = International Medical Journal. 2013;(2):79–83. (In Russ.) Available at: http://dspace.nbuv.gov.ua/xmlui/bitstream/handle/123456789/53342/17-Berezniakov.pdf?sequence=1.

7. Gavrilyuk V.P., Konoplya A.I. The role of adaptive immunity indices in the choice of surgical tactics for the treatment of appendicular peritonitis in children. Meditsinskaya immunologiya = Medical Immunology (Russia). 2015;17(S):328. (In Russ.) Available at: https://elibrary.ru/item.asp?id=24499362.

8. Vasiliev L.A., Kostyuk I.P., Ivanov S.A., Kaprin A.D. Classification of the post radiation fistulas of pelvic organs. Onkourologiya = Cancer Urology. 2019;15(2):118–123. (In Russ.) doi: 10.17650/1726-9776-2019-15-2-118-123.

9. Galchenko L.I. Radiation complIcations in Radiation Therapy. Irkutsk: ISMu; 2015. 30 p. (In Russ.) Available at: https://ismu.baikal.ru/src/downloads/3247d910_34012d01_49178e29_luchevye_oslozhneniya_pri_luchevoiy_terapii.pdf.

10. Zharikov A.A., Terekhov O.V. Pelvic cancer, radiation induced injury, diagnostics (review of literature). Radiatsiya i risk = Radiation and Risk. 2013;22(3):57–64. (In Russ.) Available at: http://www.radiation-and-risk.com/year2013/3/1294-4.


Review

For citations:


Teryushkova Z.I., Vazhenin A.V., Vasilyev V.S., Vasilyev S.A., Timerbulatov V.M. Evaluation of immediate and long-term results of treatment of post-radiation injuries of the rectum. Ambulatornaya khirurgiya = Ambulatory Surgery (Russia). 2021;18(1):82-90. (In Russ.) https://doi.org/10.21518/1995-1477-2021-18-1-82-90

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