gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLCgastro-j-1401Research ArticleНОВОСТИ КОЛОПРОКТОЛОГИИNEWS OF COLOPROCTOLOGYПодготовка больных к проведению эндоскопических исследований и хирургических вмешательств на толстой кишкеPreparation of patients for endoscopic investigations and surgery of the large intestineБашанкаевБ. Н.BashankaevB. N.ЙулдашевА. Г.YuldashevA. G.ЕрмаковД. Ф.YermakovD. F.ЦарьковП. В.TsarkovP. V.РНЦХ им. Б.В. Петровского РАМНRussian Federation2011260320112127682Copyright © Башанкаев Б.Н., Йулдашев А.Г., Ермаков Д.Ф., Царьков П.В., 20112011Башанкаев Б.Н., Йулдашев А.Г., Ермаков Д.Ф., Царьков П.В.Bashankaev B.N., Yuldashev A.G., Yermakov D.F., Tsarkov P.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/1401

Цель обзора. Осветить современную тактику подготовки больных к эндоскопическим исследованиям и проведению хирургических вмешательств на толстой кишке.Основные положения. Благодаря использованию полиэтиленгликоля (ПЭГ) обязательная очистка толстой кишки стала возможной без применения очистительных клизм. ПЭГ является высокомолекулярным линейным полимером, связывающим воду, что увеличивает объем содержащейся в кишечнике жидкости и стимулирует механорецепторы. В качестве альтернативного способа применяются препараты фосфатов натрия. Ограничивает их применение возможное развитие гиперфосфатемии у некоторых категорий больных. Подготовка толстой кишки к эндоскопическим исследованиям для обеспечения информативности процедуры требует отличного очищения просвета кишки. Перед плановыми вмешательствами подготовка необходима при лапароскопической хирургии и операциях на прямой кишке. Представлен собственный опыт ведения колоректальных больных в предоперационном периоде.Заключение. Применение препаратов ПЭГ позволяет относительно безопасно достичь качественной подготовки к хирургическим и эндоскопическим вмешательствам на толстой и прямой кишке с наименьшим количеством относительных и абсолютных противопоказаний.

The aim of review

The aim of review. To demonstrate modern approach to preparation of patients for endoscopy and colon and rectal surgery.

Original positions

Original positions. Due to application of polyethylene glycol (PEG) obligatory cleaning of the large intestine became possible without application of flush enemas. PEG is high molecular weight linear polymer retaining water that increases fluid volume in the bowel and stimulates mechanoreceptors. Application of sodium phosphates is an alternative preparation method. Risk of hyperphosphatemia that develops in some groups of patients limits their application. Preparation with excellent cleaning of large intestinal lumen is necessary for conclusive endoscopic investigation. Preparation is required as well before elective laparoscopic and rectal surgery. Authors’ experience of preoperative management of colorectal patients is presented.

Conclusion

Conclusion. Application of PEG agents allows to obtain safely high-quality preparation for surgical and endoscopic colorectal interventions with the least number of relative and absolute contraindications.

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