Аннотация

Резюме

To study the clinical course and diagnostic characteristics of chronic constipation caused by dolichosigma, as well as its association with cecum mobile syndrome and Bauhin valve insufficiency (BVI), in order to develop a prognostic model for complications and improve surgical outcomes.

Материал и методы

A prospective study of 296 patients with chronic constipation associated with dolichosigma was conducted in a coloproctology department from 2016 to 2025. Clinical assessment included Wexner, PAC-SYM, Bristol Stool Scale, and SF-36 scores. Instrumental methods: irrigography, MSCT, ileocecography, endoscopic evaluation of BVI, and ultrasound assessment of cecal mobility. Statistical analysis was performed using SPSS v.27 and R 4.3 (logistic regression, ROC analysis).

Результаты

Four morphofunctional phenotypes were identified: isolated dolichosigma (34.5%), dolichosigma + cecum mobile (21.6%), dolichosigma + BVI (26.4%), and triad syndrome (17.6%). Combined forms accounted for 65.5%. The triad phenotype demonstrated the greatest severity (Wexner 19.8±3.6; transit >72 h — 96.2%) and the highest complication rate (57.7%). A prognostic model was developed (AUC=0.84); at a threshold of ≥8 points, the risk of complications increased 6.3-fold (OR=6.34; 95% CI 3.10–12.96).

Заключение

Chronic constipation in dolichosigma is characterized by significant morphofunctional heterogeneity with a predominance of combined forms. Key predictors of complicated course include BVI, cecosigmoid index >230%, and presence of cecum mobile. The developed prognostic scale provides effective patient stratification and optimization of treatment strategy.

Ключевые слова

chronic constipation dolichosigma Bauhin valve insufficiency cecum mobile ileocecal valve morphofunctional phenotype colonic transit prognostic model risk stratification surgical treatment.

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