[Strictureplasty or resection? Optimal approach for fibrostenotic Crohn's disease]. / Strikturoplastika ili rezektsiya? Optimal'naya taktika pri fibrostenoticheskoi forme bolezni Krona.

The indications for surgical intervention in patients with Crohn's disease (CD) are ineffective therapy and complications of this disease. In case of fibrostenotic CD, strictureplasty or bowel resection are indicated. The indications for organ-sparing surgeries are multiple small bowel lesions, previous surgery for CD and short bowel syndrome. Strictureplasty is not advisable in patients with fistulas, abscesses, bowel perforation and severe hypoalbuminemia due to extremely high risk of anastomotic leakage. Therefore, bowel resection is recommended if strict indications for various types of strictureplasty are absent. This approach is associated with effective maintenance of remission and longer recurrence-free period.

[Limberg Flap reconstruction for pilonidal sinus]. / Rezul'taty khirurgicheskogo lecheniya epitelial'nogo kopchikovogo khoda s ispol'zovaniem plastiki po Limbergu.

OBJECTIVE: To compare the effectiveness of two surgical techniques in patients with pilonidal sinus. MATERIAL AND METHODS: There were 117 patients with pilonidal sinus divided into 2 groups depending on surgical approach: main group - Limberg Flap reconstruction (n=62), control group - conventional suturing of sinus (n=55). Patient data were analyzed using SPSS software. RESULTS: Mean length of hospital-stay in the main group was 8.2 days, in the control group - 5.4 days. Pain syndrome was more significant after 1 postoperative day in the main group. Three days later, severity of pain was similar in both groups. In the main group, sutures were removed after 13 days, in the control group - after 8 days. Incidence of postoperative wound infection was 3.2% in the main group and 14.5% in the control group. Long-term postoperative recurrence occurred in 1 patient of the main group and 6 patients of the control group. CONCLUSION: Limberg flap reconstruction is followed by fewer postoperative complications and recurrences. However, period of rehabilitation and wound healing is longer compared to traditional technique.

IMMUNOMODULATORY EFFECT OF ALLOGENEIC MESENCHYMAL STEM CELLS OF RATS.

INTRODUCTION: Recently, more and more attracted the attention of cell therapy, which requires a study of the efficacy and safety of allogeneic MSCs transplantation in acute and chronic inflammatory reactions. The aim of our study was to examine the effectiveness of transplantation of allogeneic mesenchymal bone marrow stromal cells for the healing of surgical wounds the glandular stomach in rats. MATERIAL AND METHODS: Using white Wistar rats. Producing cell transplantation mononuclear fraction derived from rat bone marrow aspirate. Injected cells 8 and 9 th passage. The dose of cells administered to 3-th and / or 7-th days 3,5h106 cells / ml twice or 5,0h106 cells / ml dose. Autopsy on day 10-th and 17-th. The serum ELISA determined the content of the pro- and anti-inflammatory cytokines IL1ß, TNFα, IFNy, IL-4. RESULTS AND DISCUSSION: Introduction MSCs contributed to the decline of the immune mediators of inflammation IL1P, TNFa, IFNy, increase anti-inflammatory IL4. Quality improved healing. CONCLUSION: Rapid curative effect of stem cells may be associated with the formation of blood immune cells (macrophages) that produce substances that restore damaged tissue. They restore the balance between Th1 and Th2.