ssmuБюллетень сибирской медициныBulletin of Siberian Medicine1682-03631819-3684Siberian State Medical University, the Ministry of Healthcare of the Russian Federation10.20538/1682-0363-2023-3-120-131ssmu-5318Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEW AND LECTURESВозможная роль особенностей кишечного микробиома у пациентов с колоректальным раком как причина несостоятельности анастомозаPossible role of features of the intestinal microbiome in patients with colorectal cancer as a cause of anastomotic leakhttps://orcid.org/0000-0002-0853-925XКосареваП. В.KosarevaP. V.

Косарева Полина Владимировна – доктор медицинских наук, профессор, профессор, исполняющий обязанности заведующего кафедрой пропедевтики детских болезней, ПГМУ им. акад. Е.А. Вагнера; профессор, кафедра неорганической химии, химической технологии и техносферной безопасности, ПГНИУ

614990, г. Пермь, ул. Петропавловская, 26,

614990, г. Пермь, ул. Букирева, 15

 

26, Petropavlovskaya Str., Perm, 614990,

15, Bukchireva Str., Perm, 614990

perm-bagira@yandex.ruКоневР. А.KonevR. A.

Конев Роман Андреевич – главный врач

426063 г. Ижевск, Промышленная улица, 52

52, Industrial Str., Izhevsk, 426063

cancer500@mail.ruhttps://orcid.org/0000-0002-5112-2003ГодоваловА. П.GodovalovA. P.

Годовалов Анатолий Петрович – кандидат медицинских наук, доцент кафедры микробиологии и вирусологии

614990, г. Пермь, ул. Петропавловская, 26

26, Petropavlovskaya Str., Perm, 614990

agodovalov@gmail.comСиваковаЛ. В.SivakovaL. V.

Сивакова Людмила Владимировна – кандидат медицинских наук, доцент кафедры патологической физиологии

614990, г. Пермь, ул. Петропавловская, 26

26, Petropavlovskaya Str., Perm, 614990

sivakova.lv@yandex.ruhttps://orcid.org/0000-0002-0976-8863СамоделкинЕ. И.SamodelkinE. I.

Самоделкин Евгений Иванович – профессор, доктор медицинских наук, профессор кафедры патологической физиологии

614990, г. Пермь, ул. Петропавловская, 26

26, Petropavlovskaya Str., Perm, 614990

sei-p@mail.ruПермский государственный медицинский университет (ПГМУ) им. акад. Е.А. Вагнера; Пермский государственный национальный исследовательский университет (ПГНИУ)РоссияPerm State Medical University named after Academician E.A. Wagner; Perm State UniversityRussian FederationГородская клиническая больница (ГКБ) № 9РоссияCity Clinical Hospital No. 9Russian FederationПермский государственный медицинский университет (ПГМУ) им. акад. Е.А. ВагнераРоссияPerm State Medical University named after Academician E.A. WagnerRussian Federation202318102023223120131Copyright © Косарева П.В., Конев Р.А., Годовалов А.П., Сивакова Л.В., Самоделкин Е.И., 20232023Косарева П.В., Конев Р.А., Годовалов А.П., Сивакова Л.В., Самоделкин Е.И.Kosareva P.V., Konev R.A., Godovalov A.P., Sivakova L.V., Samodelkin E.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://bulletin.ssmu.ru/jour/article/view/5318Цель исследования

Цель исследования: на основе анализа литературных данных определить значимые факторы кишечной непроходимости у пациентов с колоректальным раком (КРР).

Материалы и методы

Материалы и методы. Проанализировано 84 литературных источника из баз данных Scopus, Web of Science, Google Scholar, PubMed, а также находящихся в свободном доступе в Google.

Результаты

Результаты. Обсуждаются преобладающие причины несостоятельности анастомозов после операций по поводу КРР, анализируется роль микробиома в развитии послеоперационных осложнений. Микробиом кишечника больных КРР содержит бактерии, которые в норме не обнаруживаются в физиологических условиях, и сами эти бактерии способствуют развитию заболевания, а также несостоятельности кишечного шва после операции по поводу кишечной непроходимости, прогрессированию процесса канцерогенеза. Этот эффект обусловлен продукцией бактериальных метаболитов, влиянием на иммунную систему человека и конкуренцией с облигатной микрофлорой кишечника. Однако использование медикаментозного лечения, в том числе антибиотиков, приводит к массовой гибели облигатной микрофлоры. Поэтому важен поиск таких препаратов и методов лечения, которые по возможности не оказывают существенного негативного влияния на микробиом, но способны уничтожать патогенные микроорганизмы. Предложена концепция российских авторов, заключающаяся во внутрипросветном применении рифаксимина-α для профилактики гнойно-септических осложнений и несостоятельности анастомозов при реконструктивных операциях на дистальном отделе толстой кишки.

Заключение

Заключение. Несостоятельности анастомозов после операций по поводу КРР в значительной мере способствуют специфические для этого контингента пациентов нарушения кишечного микробиоценоза, которые могут быть устранены использованием антибактериальных препаратов.

Aim

Aim. Following the analysis of literature data, to determine significant factors of intestinal obstruction in patients with colorectal cancer.

Materials and methods

Materials and methods. We analyzed 84 literature sources from the Scopus, Web of Science, Google Scholar, and PubMed databases, as well as open access articles on Google.

Results

Results. The predominant causes of anastomotic leaks after operations for colorectal cancer are discussed, the role of the microbiome in the development of postoperative complications is analyzed. The intestinal microbiome of patients with colorectal cancer contains bacteria that are not normally found under physiological conditions. These bacteria contribute to the development of disease, suture failure after surgery for intestinal obstruction, and progression of carcinogenesis. This effect is due to the production of bacterial metabolites, the effect on the human immunity, and competition with obligate intestinal microflora. On the other hand, the use of drug therapy, including antibiotics, leads to mass death of obligate bacteria. Therefore, it is important to search for drugs and treatment methods that, if possible, do not have a significant negative impact on the microbiome, but are capable of destroying pathogenic microorganisms. The concept of Russian authors was proposed, which consists in the intraluminal use of rifaximin-α for the prevention of purulent and septic complications and anastomotic leaks during reconstructive surgeries on the distal colon.

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