Novosti
Khirurgii

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Year 2021 Vol. 29 No 6

GENERAL & SPECIAL SURGERY

V.P. ZEMLYANOY 1, B.P. FILENKO 1, B.V. SIGUA 1, P.A. KOTKOV 2, G.Y. DZALATYAN 2

PREVENTIVE MEASURES AS AN OBLIGATORY COMPONENT IN THE TREATMENT OF PATIENTS WITH ACUTE ADHESIVE BOWEL OBSTRUCTION

North-Western State Medical University named after I.I. Mechnikov 1,
Saint-Petersburg St. Elizabeth Hospital 2, Saint-Petersburg,
The Russian Federation

Objective. Reducing the recurrence rate of adhesive disease after its surgical treatment by developing a differentiated approach to preventive measures.
Methods. A retrospective study included patients (n=260) with adhesive disease complicated by recurrent attacks of acute bowel obstruction has been performed. The main (n=105) and control (n=155) groups were formed. The patients of the main group were undergone to algorithm for prophylaxis and treatment in patients providing the implementation of planned surgical treatment and measures to prevent recurrence. The nature of preventive measures was determined by the volume of surgical trauma of the peritoneal mesothelium and the prevalence of cicatricial-adhesive changes. In the control group, patients underwent standard measures aimed at conservative resolution of acute adhesive bowel obstruction: depending on their effectiveness, patients were discharged for further outpatient treatment or for urgent surgical intervention without any preventive measures. The primary outcome was considered to be the incidence and recurrence rate of adhesive disease and the severity of clinical symptoms, which were traced to a depth from 2 to 10 years by interviewing patients. If it was impossible to assess long-term results, patients were excluded from the study.
Results. The total frequency of adhesive disease relapses requiring hospitalization was 8.6% (n=9) in the main group and 27.1% (n=42) in the comparison group, respectively. The best results were obtained in the subgroup of patients operated on for adhesive disease in a planned manner - the frequency recurrence rate was 4.6%.
Conclusion. The use of the developed therapeutic and prophylactic algorithm in the surgical treatment of adhesive disease led to decline in relapse rates from 27.1 %-8.6% cases of an improvement of life quality of patients with acute adhesive intestinal obstruction who underwent surgical treatment.

Keywords: adhesive disease, abdominal adhesions, adhesiolysis, acute adhesive intestinal obstruction, prevention of adhesions, nasointestinal intubation
p. 680-687 of the original issue
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Address for correspondence:
191015, Russian Federation,
Saint-Petersburg, Kirochnaya Str., 41,
North-Western State Medical University
Named after I.I. Mechnikov, the Faculty
Surgery Department Named after I.I.Grekov,
tel. +790626192131,
e-mail: kotkovdr@mail.ru
Kotkov Pavel A.
Information about the authors:
Zemlianoi Viacheslav P., MD, Professor, Head of the Faculty Surgery Department Named after I.I.Grekov, North-Western State Medical University Named after I.I. Mechnikov, Saint-Petersburg, Russian Federation.
https://orcid.org/0000-0003-2329-0023
Filenko Boris P., MD, Professor of the Faculty Surgery Department Named after I.I.Grekov, North-Western State Medical University Named after I.I. Mechnikov, Saint-Petersburg, Russian Federation.
https://orcid.org/0000-0001-7948-9862
Sigua Badri V., MD, Professor of the Faculty Surgery Department named after I.I.Grekov, North-Western State Medical University Named after I.I. Mechnikov, Saint-Petersburg, Russian Federation.
https://orcid.org/0000-0002-4556-4913
Kotkov Pavel A., PhD, Surgeon, the Surgery Unit No2, Saint-Petersburg St. Elizabeth Hospital, Saint-Petersburg, Russian Federation.
https://orcid.org/0000-0002-9762-9854
Dzhalatyan Garii Yu., Surgeon, the Surgery Unit No2, Saint-Petersburg St. Elizabeth Hospital, Saint-Petersburg, Russian Federation.
https://orcid.org/0000-0001-6075-2085
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