Differentiated approach to choice of method for the small bowel transplant shifting into the small pelvis cavity


Keywords: reconstructive-restoration operations; large bowel; transplant of small bowel

Abstract

Objective. To improve the results of reconstructive-restoration operations after colectomy with a super-low anterior rectal resection due to optimization of the method, which provide a free shifting of a small bowel transplant into a small pelvis cavity.

Маterials and methods. There were elaborated a new methods of shifting of the small bowel transplant while conduction of reconstructive-restoration operations after colectomy with a super-low anterior rectal resection, mucosectomy of surgical anal channel, which must be accompanied with mobilization of a small bowel mesentery root, transection of vascular arcade of upper mesenterial artery (UMA) and her direct vessels. These procedures were applied in 32 patients in combination with the known methods in complex аnatomical peculiarities of the small bowel mesentery, its ileal part localization, and the UMA architectonics.

Results. The complications in early postoperative period, caused by the small bowel transplant shifting into the small pelvis cavity in the patients operated were absent. In late postoperative period in 1 (3.1%) patient an ischemic reservoiritis have occurred, which was not caused by the shifting procedure peculiarities.

Conclusion. The elaborated new methods of the small bowel transplant shifting after resection of ileal terminal portion promotes enhancement of its length and improvement of mobility. Differentiated approach for application of a new elaborated methods for shifting of a small bowel transplant in complex of known  methods have guaranteed the transplant transposition into the small pelvis cavity in complex anatomic environment, caused by reduction of length of the ileum terminal portion without tension to a small bowel mesentery, as well as the essential risk for its ischemia and necrosis occurrence.

References

1. Vorobey AV, Grishin IN. Reabilitacija stomrovannyh bolnyh. Minsk: Belorusskaya nauka; 2003. 190 s. [In Russian].

2. Poyda AI, Melnik VM. Vosstanovitelnye i rekonstruktivno-vosstanovitelnye operacii na tolstoj kishke. Kyiv: Izdatelskiy centr «Imidzh Ukriiny»; 2014. 368 s. [In Russian].

3. Melnyk VM, Poyda OI, vynakhidnyky; Natsionalniy medichniyi universitet imeni O. O. Bohomoltsia, patentovlasnyk. Sposib dyslokatsii tonkokyshkovoho transplantata u porozhnynu maloho taza. Patent Ukrainy N 71956. 2012 lip 14. [In Ukrainian].

4. Melnyk VM, Poyda OI, vynakhidnyky; Natsionalniy medichniyi universitet imeni O. O. Bohomoltsia, patentovlasnyk. Sposib mobilizatsii tonkokyshkovoho transplantata. Patent Ukrainy N 128180. 2018 ver 17. [In Ukrainian].

5. Melnyk VM, Poyda OI, Kadir Abdulrakhman Abdul, vynakhidnyky; Natsionalniy medichniyi universitet imeni O. O. Bohomoltsia, patentovlasnyk. Sposib formuvannia tonkokyshkovoho tazovoho rezervuara. Rishennia pro vydachu deklaratsiinoho patentu na korysnu model, Ukraina. u 2018 02861. 2018. lip. [In Ukrainian].

6. Melnyk VM, Poyda OI, vynakhidnyky; Natsionalniy medichniyi universitet imeni O. O. Bohomoltsia, patentovlasnyk. Sposib ileoendoanalnoho anastomozu. Patent Ukrainy N 127364. 2018 lip 14. [In Ukrainian].

Author Biographies


V. M. Melnyk, Bogomolets National Medical University, Kyiv

Volodymyr Melnyk - Doctor of Medical Sciences, associate professor

Department of Surgery No. 1

Bogomolets National medical university.

01030,Taras Shevchenko blvd, 17, Kiev, Ukraine.,

+38 044 234 66 49;

qwerasd.v@ukr.net

ORSID: http://orcid.org/0000-0003-4788-546X


O. I. Poyda, Bogomolets National Medical University, Kyiv

Alexander Poyda - Doctor of Medical Sciences, Professor

Department of Surgery No. 1

Bogomolets National medical university.

01030,Taras Shevchenko blvd, 17, Kiev, Ukraine.,

+38 044 234 66 49;

poyda1409@gmail.com

ORSID: http://orcid.org/0000-0001-9443-6304

Published
2018-11-01
How to Cite
Melnyk, V. M., Poyda, O. I., & Qadir, A. A. (2018). Differentiated approach to choice of method for the small bowel transplant shifting into the small pelvis cavity. Klinicheskaia Khirurgiia, 85(11), 18-21. https://doi.org/10.26779/2522-1396.2018.11.18
Section
General Problems of Surgery