Simultaneous minimally invasive operations in coloproctological patients with combined surgical diseases on an outpatient basis
https://doi.org/10.21518/akh2026-016
Abstract
Introduction. Due to the active introduction of high-tech minimally invasive surgical interventions into clinical practice, there has been a noticeable increase in the interest of surgeons in simultaneous surgeries in recent years. This is particularly true for the possibilities of performing simultaneous minimally invasive surgeries on an outpatient basis.
Aim. To evaluate the clinical effectiveness of simultaneous operations in coloproctological patients with various combined surgical diseases in an outpatient hospital.
Materials and methods. A simple observational prospective-retrospective study design was applied (for the period from January 2021 to December 2024).The results of simultaneous surgeries performed in hospital-free conditions in 205 patients with a combination of various coloproctological diseases (chronic hemorrhoids of stages II–III – 113 (55.1%) patients, chronic anal fissure – 50 (24.4%) patients, pilonic cysts of the coccyx – 31 (15.1%) patients,low transsphincteric anorectal fistulas – 11 (5.4%) patients) with other surgical pathologies were analyzed. In 38(18.5%) patients, coloproctological diseases were combined with abdominal wall hernias, in 91(44.4%) – with urological pathology, and in 76 (37.1%) – with gynecological diseases.
Results. Simultaneous surgeries in coloproctology patients with various combined surgical diseases were not accompanied by additional technical difficulties, did not significantly increase trauma of the surgery, and did not have a decisive impact on the anesthetic support. The median duration of the surgical intervention was 55 (48; 62) minutes. No serious intraor postoperative complications were observed. The average hospital stay for patients after simultaneous surgeries was 12 (8; 24) hours.
Conclusion. The results we obtained indicate the effectiveness of simultaneous operations in coloproctological patients with various combined surgical pathologies, which allows us to reasonably recommend the use of minimally invasive inpatient-substituting surgical technologies in outpatient coloproctology.
About the Authors
B. M. BelikRussian Federation
Boris M. Belik, Dr. Sci. (Med.), Head of the Department of General Surgery
29, Nakhichevan Lane, Rostov-on-Don, 344022
A. N. Kovalev
Russian Federation
Aleksei N. Kovalev, Cand. Sci. (Med.), Assistant at the Department of General Surgery, Rostov State Medical University; Coloproctologist-Surgeon; International Medical Center “URO-PRO”
29, Nakhichevan Lane, Rostov-on-Don, 344022,
108, 40let Pobedy, Krasnodar, 350901
V. V. Skorlyakov
Russian Federation
Vladimir V. Skorlyakov, Cand. Sci. (Med.), Associate Professor of the Department of General Surgery
29, Nakhichevan Lane, Rostov-on-Don, 344022
References
1. Shikhmetov AN, Osin LA, Zadikyan AM, Pazichev AA. Stationary replacement technologies in the surgical treatment of simultaneous pathology in gynecological patients. Ambulatornaya Khirurgiya. 2018;(1-2):64–71. (In Russ.) https://doi.org/10.21518/1995-14772018-1-2-64-71.
2. Al-Saadi BM, Hashim MQ, Al-Saffar AF. Evaluation of The Results of The Effect of Hemorrrhoid Surgery on Urological Patients. Cent Asian J Med Nat Sci. 2025;6(4):1617–1625. https://doi.org/10.51699/cajmns.v6i4.2881.
3. Valiev A.A., Gataullin B.I., Zankina A.P., Gataullin I.G., Khasanov R.Sh., Valitov B.R. Early results of simultaneous laparoscopic operations for colorectal cancer with liver metastases. Koloproktologia. 2025;24(2):52–59. (In Russ.) https://doi.org/10.33878/2073-7556-2025-24-2-52-59.
4. Mamajanova SO. Simultaneous operations for combined surgical and gynecological diseases. Int J Artific Intel. 2024;4(2):20–21. Available at: https://www.academicpublishers.org/journals/index.php/ijai/article/view/290.
5. Kukosh MV, Fedorov VE, Logvina OA. Simultaneous operations, their importance and the feasibility of implementation. Moscow Surgical Journal. 2019;(3):81–89. (In Russ.) https://doi.org/10.17238/issn2072-3180.2019.3.81-89.
6. Golbraich VA, Maskin SS, Matyukhin VV, Klimovich IN, Harutyunyan AG. Modern approaches to simultaneous operations (indications, execution algorithms, complications). Journal of Volgograd State Medical University. 2021;18(2):28–36. (In Russ.) https://doi.org/10.19163/1994-9480-2021-2(78)-28-36.
7. Timerbulatov VM, Mekhdiev DI, Timerbulatov ShV, Sagitov RB, Iamalov RA, Gainullina EN. Simultaneous abdominal and retroperitoneal surgery. Pirogov Russian Journal of Surgery. 2016;(3):40–44. (In Russ.) https://doi.org/10.17116/hirurgia2016340-44.
8. Ponomarenko AA, Shelygin YuA, Rybakov EG, Achkasov SI. Simultaneous and staged resections for synchronous colorectal liver metastases: meta-analysis. Koloproktologia. 2017;(3):6–21. (In Russ.) https://doi.org/10.33878/2073-7556-2017-0-3-6-21.
9. Белик БМ, Ковалев АН. Симультанное хирургическое лечение анальной трещины и хронического геморроя в условиях стационара «одного дня». В: Кондратенко ГГ, Руммо ОО, Протасевич АИ (ред.). Хирургия Беларуси – состояние и развитие: сборник материалов научно-практическая конференция с международным участием и XVII Съезда хирургов Республики Беларусь. Могилев, 12–13 октября 2023 г. Минск; 2023. С. 581–583. Режим доступа: https://rep.bsmu.by/handle/BSMU/38364.
10. Wang D, Liu Z, Zhou J, Yang J, Chen X, Changet C et al. Barriers to implementation of enhanced recovery after surgery (ERAS) by a multidisciplinary team in China: a multicentre qualitative study. BMJ Open. 2022;12(3):e053687. https://doi.org/10.1136/bmjopen-2021-053687.
11. Zatevachin II, asechnik IN. Тhe program of accelerated recovery in surgery (fast trak) has been introduced. Wgat’s the next? Grekov's Bulletin of Surgery. 2018;177(3):70–75. (In Russ.) https://doi.org/10.24884/0042-4625-2018-177-3-70-75.
12. Nechaev OI. Outpatient Surgery Trend in Modern Healthcare. Zdorovye Megapolisa. 2023;4(4):112–121. (In Russ.) https://doi.org/10.47619/2713-2617.zm.2023.v.4i4;112-121.
13. Белик Б.М., Ковалев А.Н., Ефанов С.Ю., Скорляков В.В., Родаков А.В. Симультанные оперативные вмешательства у больных колопроктологического профиля в условиях стационара «одного дня». В: Материалы XV съезда РОХ совместно с IX конгрессом московских хирургов, Москва, 24–26 октября 2023 г. М.: Российское общество хирургов; 2023. С. 471–473. Режим доступа: https://endoexpert.ru/stati/sbornik-tezisov-xv-sezda-khirurgov-rossii/.
14. Zhang C, Shariq O, Bews K, Poruk K, Mrdutt M, Fosteret T et al. Outpatient surgery benchmarks and practice variation patterns: case controlled study. Int J Surg. 2024;110(10):6297–6305. https://doi.org/10.1097/JS9.0000000000001392.
15. Toleubaev EA, Alibekov AE, Balykbaeva AM, Mamytov BA. Simultaneous operations in abdominal surgery. Medicine and Ecology. 2021;(1):47–53. (In Russ.) Available at: https://medecol.qmu.kz/jour/article/view/254.
16. Samartsev VA, Gavrilov VA, Parshakov AA, Kuznetsova MP, Pushkarev BS. Simultaneous interventions in surgical gastroenterology and herniology: prediction and prevention of complications. Experimental and Clinical Gastroenterology. 2023;(6):79–83. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-214-6-79-83.
17. Khryanin AA, Markarian DR, Agapov MA, Bocharova VK. Gynecological conditions related to the perianal area and coloproctology. Gynecology. 2021;23(6):472–479. (In Russ.) https://doi.org/10.26442/20795696.2021.6.201150.
18. Belik BM, Kovalev AN, Khatlamadzhiyan AL. Administration of phlebotropic drugs during complex treatment of acute hemorrhoids. Koloproktologia. 2018;(2):48–53. (In Russ.) https://doi.org/10.33878/2073-7556-2018-0-2-48-53.
19. Smalbroek BP, Schuffel I, Weijs TJ. Twenty-four Hours Stay After Colorectal Surgery; A Systematic Review. J Coloproctol. 2023;43(3):235–242. https://doi.org/10.1055/s-0043-1773783.
20. Belik BM, Kovalev AN. Effectiveness of minimally invasive and surgical methods of treatment of chronic hemorrhoids using phlebotonics. Koloproktologia. 2023;22(2):49–56. (In Russ.) https://doi.org/10.33878/2073-7556-2023-22-2-49-56.
21. Stepanenko AV, Samoylov VS, Soloviev AI. The first experience of simultaneous submucous laser destruction of hemorrhoids during laparoscopic sleeve gastrectomy and cholecystectomy in an obese patient. Moscow Surgical Journal. 2021;(4):40–46. (In Russ.) https://doi.org/10.17238/2072-3180-2021-4-40-46.
22. Belik BM, Kovalev AN. The use of autologous platelet-rich plasma in the complex treatment of anal fissure combined with anal sphincter spasm in non-hospital settings. Koloproktologia. 2022;21(1):50–58. (In Russ.) https://doi.org/10.33878/2073-7556-2022-21-1-50-58.
23. Alyaev YG, Carkov PV, Bezrukov EA, Kravchenko AYu, Proskura AV. Urology lessons for colorectal surgeons. Urologiia. 2015;(4):112–116. (In Russ.) Available at: https://urologyjournal.ru/articles/Uroki-urologii-dlya-kolorektalnyh-hirurgov.html.
24. Sulima AN, Basnaeva AD. Fast track program in operative gynecology. Russian Bulletin of Obstetrician-Gynecologist. 2020;20(1):81–86. (In Russ.) https://doi.org/10.17116/rosakush20202001181.
25. Bayramov NYu, Gadirova AS. Endovideosurgery in diagnosis and treatment of gynecological and surgical comorbidities. Endoscopic Surgery. 2009;15(5):17–20. (In Russ.) Available at: https://elibrary.ru/lftxab.
26. Garmanova TN, Markarian DR, Kazachenko EA, Lukyanov AM, Kazachenko MA, Agapov MA. Multimodal approach to anesthesia in anorectal surgery. Russian Journal of Gastroenterology, Hepatology, and Coloproctology. 2023;33(1):15–23. (In Russ.) https://doi.org/10.22416/1382-4376-2023-33-1-15-23.
27. Lin Y-M, Yu C, Xian G-Z. Calculation methods for intraoperative blood loss: a literature review. BMC Surg. 2024;24(1):394. https://doi.org/10.1186/s12893-024-02699-3.
28. Burikov MA, Kulikov AG. One-day surgery. Treatment for anterior abdominal wall hernias in day patient department of a clinic. Moscow Surgical Journal. 2022;(3):43–49. (In Russ.) https://doi.org/10.17238/2072-3180-2022-3-43-49.
29. Calegari R, Fogliatto FS, Lucini FR, Anzanello M, Schaan B. Surgery scheduling heuristic considering OR downstream and upstream facilities and resources. BMC Health Serv Res. 2020;20(1):684. https://doi.org/10.1186/s12913-020-05555-1.
Review
For citations:
Belik B.M., Kovalev A.N., Skorlyakov V.V. Simultaneous minimally invasive operations in coloproctological patients with combined surgical diseases on an outpatient basis. Ambulatornaya khirurgiya = Ambulatory Surgery (Russia). 2026;23(1):126-135. (In Russ.) https://doi.org/10.21518/akh2026-016
JATS XML
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International.






















