Miniinvasive method of treatment of the duodenal sutures insufficiency

Keywords: duodenal sutures insufficiency; miniinvasive treatment; nitinol stent.

Abstract

Objective. To improve the results of treatment in patients with insufficiency of duodenal sutures.

Materials and metods. Retrospective and prospective investigation was accomplished on 17 patients, suffering insufficiency of sutures, injuries and fistulas of duodenum, who were admitted for treatment into Shalimov National Institute of Surgery and Transplantology during 2010-2020 yrs. In all the patients a complex examination, including a general clinical one, special laboratory and instrumental methods of investigation, was conducted.

Results. Miniinvasive endoscopic method for the treatment of the duodenal sutures insufficiency was elaborated with a patent obtaining, which consists of endoscopic placement of a covered nitinol self-expanding stent into the defect zone. In presence of the complication, constituting a duodenal fistula, there was proposed to place a covered nitinol self-expanding stent into the defect zone together with vacuum-therapy from the side of the fistula external aperture. Due to application of the treatment method elaborated, it have become possible to reduce the morbidities quantity and to shorten the patients’ stationary stay by 36% - from (38.1 ± 4.16) to (25.4 ± 3.7) bed-days (p < 0.05). General mortality in the investigated group have constituted 9%, what was in two times lower, than the mortality index in a control group - 16%.

Conclusion. The method, investigated by us, have constituted a combined approach with endoscopic placement of a self-expanding stent into the defect zone together with vacuum therapy from the external aperture of fistula, promoting improvement of the treatment results of the duodenal sutures insufficiency, accompanied by shortening of the patients’ stationary stay and reduction of morbidity and mortality.

Author Biographies

O. Yu. Usenko, Shalimov National Institute of Surgery and Transplantology, Kyiv

Usenko Olexandr Yu., MD, DSci(Med), Professor;
Director of the Shalimov National Institute of Surgery and Transplantology,
Head of the department of Toracoabdominal Surgery;
Kyiv, 30 Heroiv Sevastopolia str.
+38 (044) 454 70 50
ausenko1962@gmail.com
https://orcid.org/0000-0003-4957-4104

Ya.Yu. Voitiv, Shalimov National Institute of Surgery and Transplantology, Kyiv

Voitiv Yaroslav Yu. - MD, PhD (Med), Associate Professor, Surgeon
Department of Toracoabdominal Surgery
Shalimov National Institute of Surgery and Transplantology,
30 Heroyv Sevastopolya Str., 03680, Kyiv, Ukraine
+38 044 497 1374
voitiv.yaroslav@gmail.com
orcid.org/0000-0003-2638-9352

I. S. Tereshkevich, Shalimov National Institute of Surgery and Transplantology, Kyiv

Tereshkevich Ivan S. - MD, PhD(Med), Senior Scientific Researcher
Laboratory of Interventional Endoscopy,
Shalimov National Institute of Surgery and Transplantology,
30 Heroyv Sevastopolya Str., 03680, Kyiv, Ukraine
+38 044 497 1374
tis_v@ukr.net
orcid. org/0000-0001-6761-956X

O. S. Tyvonchuk, Shalimov National Institute of Surgery and Transplantology, Kyiv

Tyvonchuk Olexandr S. - MD, DSci(Med), Head Scientific Researcher
Department of Toracoabdominal Surgery
Shalimov National Institute of Surgery and Transplantology,
30 Heroyv Sevastopolya Str., 03680, Kyiv, Ukraine
+380505047127
o.tyvonchuk@gmail.com
orcid.org/0000-0002-6835-891X

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Published
2020-07-24
How to Cite
Usenko, O. Y., Voitiv, Y., Tereshkevich, I. S., & Tyvonchuk, O. S. (2020). Miniinvasive method of treatment of the duodenal sutures insufficiency. Klinicheskaia Khirurgiia, 87(5-6), 21-25. https://doi.org/10.26779/2522-1396.2020.5-6.21
Section
General Problems of Surgery

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