Estimation of efficacy of combined application of prophylactic methods for insufficiency of the intestinal anastomoses sutures
Objective. Studying of efficacy and combination of different prophylactic methods for insufficiency of the intestinal anastomoses sutures (IIAS) in the patients after elective, urgent and emergent resection of various intestinal segments.
Materials and methods. There were studied the results of treatment of 642 patients, in whom resection of various segments of small and large bowel with formation of primary anastomoses was performed. Of 642 patients 357 (55.6%) were operated in elective order, 285 (44.4%) - in accordance to urgent and emergent indications. In 467 (72.7%) patients the anastomoses were formatted in side-to-side fashion, in 150 (23.4%) - the end-to-end, in 25 (3.8%) - the end-to-side. Permanent intramesenterial (retroperitoneal) blockades were performed, the lymphotropic therapy, local laseromagnet therapy, the intubation decompression, sanation and gastroenterosorption with polyphepan, as well as the human placental hydrolysate «Laennec» preparation, injected intramuscularly, were conducted for the IIAS prophylaxis.
Results. IIAS was observed in 10 (1.6%) patients: in 6 (4.0%) - with anastomoses end-to-end and in 4 (0.86%) - with anastomoses side-to-side. There were insufficient 1 (10%) anastomosis between the small and large bowel, 2 (20%) - between parts of the small bowel and 7 (70%) - between parts of a large bowel.
Conclusion. Permanent intramesenterial (retroperitoneal) blockade with lymphotropic therapy, local laseromagnet therapy, the intubation decompression, sanation and gastroenterosorption with polyphepan, as well as «Laennec» preparation are recommended in accordance to indications for the IIAS prophylaxis in patients, operated in emergent, urgent and elective order.
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