Publications by authors named "Inna A Tulina"

9 Publications

  • Page 1 of 1

A technical guide for everted natural orifice specimen extraction after low anterior resection of the rectum - a video vignette.

Colorectal Dis 2021 03 25;23(3):766-767. Epub 2021 Feb 25.

I. M. Sechenov First Moscow State Medical University, Sechenov University, Moscow, Russia.

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http://dx.doi.org/10.1111/codi.15495DOI Listing
March 2021

Combined surgical approach for large sacral chordoma resection with pelvic floor reconstruction - a video vignette.

Colorectal Dis 2021 02 24;23(2):566-567. Epub 2020 Nov 24.

I.M. Sechenov First Moscow State Medical University (Sechenov University, Moscow, Russia.

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http://dx.doi.org/10.1111/codi.15436DOI Listing
February 2021

Extended Colectomy Followed by Cecorectal Anastomosis as a Surgical Treatment Modality in Synchronous Colorectal Cancer.

Case Rep Oncol 2020 May-Aug;13(2):813-821. Epub 2020 Jul 8.

Coloproctology and Minimally Invasive Surgery Clinic, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.

Subtotal and extended left colectomies with ileocecal junction preservation represent preferable alternatives in cases of massive involvement of the colon in the pathological process. However, these approaches might be challenging in terms of reconstructive steps. Antiperistaltic cecorectal anastomosis is one of the possible techniques. Still, this type of pouch formation is described mostly in slow-transit constipation surgical management. We report on a patient with synchronous colorectal cancer who underwent extended left colectomy. In the case of compromised vessel anatomy, it was decided to perform antiperistaltic cecorectal anastomosis. We present all clinical and intraoperative patient's data, determining the surgical tactics, and short-term postoperative results. An antiperistaltic cecorectal anastomosis can be considered in nonstandard clinical cases and variable anatomy of the patient.
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http://dx.doi.org/10.1159/000508266DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7443643PMC
July 2020

3D-printed pubic bone for pelvic ring reconstruction after exenteration for anal cancer recurrence.

Br J Surg 2020 10 26;107(11):e512-e514. Epub 2020 Aug 26.

I.M. Sechenov First Moscow State Medical University (Sechenov University), Clinic of Coloproctology and Minimally Invasive Surgery, Moscow, Russia.

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http://dx.doi.org/10.1002/bjs.11982DOI Listing
October 2020

Surgical Treatment of Sacral Chordoma: The Role of Laparoscopy.

Case Rep Oncol 2020 Jan-Apr;13(1):255-260. Epub 2020 Mar 24.

I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.

Sacral chordoma is a rare tumour that represents the most common malignancy of the sacral region. Its diagnosis can be delayed because of unclear clinical manifestation. This tumour can involve surrounding anatomical structure such as the rectum, and its surgical treatment is still challenging. We report on 3 patients with sacral chordoma. Two of them were successfully treated using a laparoscopic approach and one by open surgery. We present all details of the surgical technique and patients' outcome. Minimally invasive methods in the surgical treatment of chordoma allow to perform a radical dissection of the tumour, minimizing the operative trauma. A laparoscopic approach can be considered safe and radical for sacral chordoma treatment.
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http://dx.doi.org/10.1159/000506441DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7154265PMC
March 2020

Three-plane Model to Standardize Laparoscopic Right Hemicolectomy with Extended D3 Lymph Node Dissection.

Surg Technol Int 2020 May;36:136-142

Minimally Invasive Surgery, Department of Surgery, Clinic of Colorectal and Minimally Invasive Surgery, I.M. Sechenov First Moscow State Medical, University, Moscow, Russia.

Aim: The purposes of this study were to create a "three-plane model" for laparoscopic right hemicolectomy and to compare short-term outcomes of anterior medial-to-lateral (aM-to-L) and caudal-to-cranial access by retroperitoneal tunneling (Ca-to-Cr), as described based on the three-plane model.

Methods: A three-plane model was developed to clarify the steps of an operation. Consecutive cases of right colon cancer were operated upon with an aM-to-L approach in the earlier period and then with a Ca-to-Cr approach, and postoperative outcomes were evaluated. Short-term results were compared.

Results: Sixty-two patients were divided into aM-to-L (n=29) and Ca-to-Cr (n=33) groups. The two groups did not differ in terms of the patients' baseline characteristics. Median operative time was 220 min (IQR 190-260) for the aM-to-L group and 222.5 min (IQR 180-255) for the Ca-to-Cr group (p=0.73). Estimated blood loss was similar in both groups (p=0.13). Median length of hospital stay was 6 days (IQR 5-8) in the aM-to-L group and 7 days (IQR 6-9) in the Ca-to-Cr group (p=0.17). Median number of harvested lymph nodes was 45.5 (IQR 25-44.9) in the aM-to-L group and 30 (IQR 18-48.5) in the Ca-to-Cr group (p=0.34).

Conclusion: The approach used to reach the superior mesenteric vessels for laparoscopic right hemicolectomy with D3 lymph node dissection does not affect the short-term outcome of the operation. The present three-plane model gives surgeons additional insight to perform this operation.
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May 2020

Uni-center, patient-blinded, randomized, 12-month, parallel group, noninferiority study to compare outcomes of 3-row vs 2-row circular staplers for colorectal anastomosis formation after low anterior resection for rectal cancer.

Medicine (Baltimore) 2019 Jun;98(24):e15978

Department of Surgery, Faculty of Preventive Medicine, Clinic of Colorectal and Minimally Invasive Surgery, Sechenov First Moscow State Medical University, Moscow, Russian Federation.

Background: Colorectal anastomotic leakage (AL) is one of the most serious complications in rectal cancer surgery due to its negative impact on the overall as well as cancer-specific survival. Two-row stapling technique has become standard in low anterior resections (LARs), but has neither alleviated the morbidity, nor reduced the incidence of AL. This is the 1st study that aims to compare the success rate of new 3-row circular staplers compared to that of conventional 2-row staplers in a prospective, randomized clinical trial.

Methods: The THREESTAPLER trial (Clinical Trials NCT03910699) is a prospective, noninferiority, 2-armed, parallel-group, patient and outcomes assessor blinded study with a 1:1 allocation ratio. Colorectal anastomosis will be formed using Ethicon 29 mm Curved Intraluminal Stapler (CDH29A) in the active comparator group, and using Mirus Disposable Circular Stapler 3 Row 29 (MCS-29R3) in the experimental group. The hypothesis states that the incidence of AL in the 3-row stapler group is at least not higher than in the 2-row stapler group. Assuming there is a difference in success rate of 12% and noninferiority margin Δ = 5%, 154 patients will be required to achieve statistical significance. An interim analysis will be performed after recruitment of 20 patients per group to assess safety profile of 3-row circular staplers. The primary endpoint is the rate of AL, documented by imaging studies, assessed with Pearson Chi-squared test and Fisher exact test. The secondary outcomes include severity of AL (A, B, or C), anastomotic bleeding, postoperative complication rate graded with the Clavien-Dindo classification, reintervention rate, stapler dysfunction rate, complications of defunctioning stoma, overall and cancer-specific quality of life, assessed with short form (36) and quality-of-life questionnaire core 30 questionnaires, respectively, fecal incontinence assessed with Cleveland clinic incontinence score form, and manifestation of LAR syndrome. All patients will be monitored for 12 months following the LAR.

Discussion: This is the 1st prospective randomized trial to assess the safety profile of 3-row staplers for colorectal anastomosis after LAR for rectal cancer. It may provide evidence of feasibility of 3-row circular staplers in LAR with respect to short-term and long-term patient outcomes.

Trial Registration: NCT03910699 on 10 April 2019.
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http://dx.doi.org/10.1097/MD.0000000000015978DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6587660PMC
June 2019
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