mossjМосковский хирургический журналMoscow Surgical Journal2072-3180ООО «ПРОФИЛЬ – 2С»10.17238/2072-3180-2025-3-20-34mossj-1019Research ArticleАБДОМИНАЛЬНАЯ ХИРУРГИЯABDOMINAL SURGERYРанние парастомальные осложнения у пациентов после ургентных кишечных стомийEarly parastomal complications in patients after urgent ostomyhttps://orcid.org/0000-0003-1327-6973РогальМ. М.RogalM. M.

Рогаль Михаил Михайлович – к.м.н, врач-хирург, старший научный сотрудник отдела неотложной хирургии, эндоскопии и интенсивной терапии

129090, г. Москва, пл. Сухаревская Б., д.3, Москва 

Rogal Mikhail Mikhailovich – MD, surgeon, research associate, Department of Emergency Surgery, Endoscopy and Intensive Car

129090, Bolʹshaya Sukharevskaya Ploshchadʹ, 3, Moscow

https://orcid.org/0000-0003-1270-5414ЯрцевП. А.YartsevP. A.

Ярцев Петр Андреевич – д.м.н., профессор, врач-хирург высшей квалификационной категории, руководитель научного отдела неотложной хирургии, эндоскопии и интенсивной терапии

129090, г. Москва, пл. Сухаревская Б., д.3, Москва 

Yartsev Petr Andreevich – Doctor of Medical Sciences, Professor, Head of the Scientific Department of Emergency Surgery, Endoscopy and Intensive Care.

129090, Bolʹshaya Sukharevskaya Ploshchadʹ, 3, Moscow

https://orcid.org/0000-0003-1051-7663РогальМ. Л.RogalM. L.

Рогаль Михаил Леонидович – д.м.н., профессор, зам. директора по научной работе

129090, г. Москва, пл. Сухаревская Б., д.3, Москва 

Rogal Mikhail Leonidovich – MD, Professor, Deputy Director for Scientific Work, Department of Emergency Surgery, Endoscopy and Intensive Care

129090, Bolʹshaya Sukharevskaya Ploshchadʹ, 3, Moscow

https://orcid.org/0000-0003-4008-6462ЛебедевА. Г.LebedevA. G.

Лебедев Александр Георгиевич – д.м.н., врач-хирург, главный научный сотрудник отдела неотложной хирургии, эндоскопии и интенсивной терапии

129090, г. Москва, пл. Сухаревская Б., д.3, Москва 

Lebedev Alexander Georgievich – MD, Chief Scientific Officer, Department of Emergency Surgery, Endoscopy and Intensive Care

129090, Bolʹshaya Sukharevskaya Ploshchadʹ, 3, Moscow

https://orcid.org/0000-0001-8319-7440СтинскаяН. А.StinskayaN. A.

Стинская Надежда Александровна – научный сотрудник 

129090, г. Москва, пл. Сухаревская Б., д.3, Москва, 8-968-993-76-96 

Stinskaya Nadezhda Aleksandrovna – researche 

129090, Bolʹshaya Sukharevskaya Ploshchadʹ, 3, Moscow, Tel: 8-968-993-76-96 

vasacorona@yandex.ruhttps://orcid.org/0000-0002-1687-1308ЦулеискириБ. Т.TsuleiskiriB. T.

Цулеискири Бакур Темурович – к.м.н., заведующий хирургическим отделением

129090, г. Москва, пл. Сухаревская Б., д.3, Москва 

Tsuleiskiri Bakur Temurovich – MD, Department of Emergency Surgery, Endoscopy and Intensive Care

129090, Bolʹshaya Sukharevskaya Ploshchadʹ, 3, Moscow

ГБУЗ Научно-исследовательский институт скорой помощи им Н.В. СклифосовскогоРоссияN. V. Sklifosovsky Research Institute For Emergency MedicineRussian Federation202522092025032034Copyright © Рогаль М.М., Ярцев П.А., Рогаль М.Л., Лебедев А.Г., Стинская Н.А., Цулеискири Б.Т., 20252025Рогаль М.М., Ярцев П.А., Рогаль М.Л., Лебедев А.Г., Стинская Н.А., Цулеискири Б.Т.Rogal M.M., Yartsev P.A., Rogal M.L., Lebedev A.G., Stinskaya N.A., Tsuleiskiri B.T.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.mossj.ru/jour/article/view/1019

Введение. Несмотря на совершенствование хирургических техник и тщательность предоперационного обследования пациентов, послеоперационных осложнений не всегда удается избежать. Послеоперационные осложнения ухудшают состояние пациента, вплоть до летального исхода, увеличивают длительность госпитализации, снижают качество оказываемой помощи.Цель исследования. Выявить факторы риска развития ранних послеоперационных осложнений у пациентов с сформированными кишечными стомам.Материалы и методы. В ретроспективное исследование вошли 140 пациентов за период с апреля 2022 по июль 2023 (14 месяцев), которые были прооперированы в НИИ СП им. Н.В. Склифосовского в связи с различной патологией органов брюшной полости с формированием стом. Пациенты были разделены на две группы (без осложнений, с осложнениями). Парастомальные осложнения (исключая дерматит) были выявлены у 13 пациентов (9,3 %). Женщин было больше, чем мужчин в обеих группах. Средний возраст пациентов с парастомальными осложнениями составил 60,8 ± 14,9 года, в группе без осложнений – 67,8 ± 14,6. Для оценки возможности сравнения групп и значимости отличий сравниваемых параметров применялись: t-критерий Стьюдента, χ2 (критерий Пирсона).Результаты. При анализе полученных данных основная группа пациентов, имеющих те или иные ранние парастомальные осложнения – это пациенты пожилого возраста, с высоким индексом массы тела (ИМТ), имеющие более двух коморбидных хронических заболеваний. Однако 69,2 % парастомальных осложнений были связаны с техническими погрешностями во время оперативного вмешательства.Заключение. С целью снижения ранних послеоперационных осложнений требуется тщательная периоперационная диагностика, выявление и оценка коморбидного фона, а также совершенствование техники выполнения оперативного вмешательства для уменьшения интраоперационных погрешностей.

Introduction. Despite the improvement of surgical techniques and thorough preoperative examination of patients, postoperative complications cannot always be avoided. Postoperative complications worsen the patient's condition, up to a fatal outcome, increase the length of hospital stay, and reduce the quality of care provided.The purpose of the study. To identify risk factors for early postoperative complications in patients with formed intestinal stomas.Materials and methods of research. The retrospective study included 140 patients from April 2022 to July 2023 (14 months) who underwent surgery at the N.V. Sklifosovsky Research Institute in connection with various disease of the abdominal organs with the formation of a stoma. The patients were divided into two groups (without and with complications). Parastomal complications (excluding peristomal dermatitis) were detected in 13 patients (9,3 %). There were more women than men in both groups. The mean age of patients with parastomal complications was 60,8 ± 14,9 years, in the group without complications – 67,8 ± 14,6. To assess the possibility of comparing groups and the significance of differences in the compared parameters, t-test, χ2 were used.Results. Analyzing the data obtained, the main group of patients with certain early parastomal complications are elderly patients with a high body mass index (BMI) and with more than two comorbid chronic diseases. However, 69,2 % of parastomal complications were related to the technical mistakes during surgery.Conclusion. In order to reduce early postoperative complications, careful preoperative diagnosis, identification and assessment of the comorbid background, as well as improvement of the technique of surgical intervention to reduce intraoperative mistakes are required.

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