ENDOGENOUS INTOXICATION INFLUENCE ON THE DEVELOPMENT OF COMPLICATIONS AFTER TREATMENT OF OPERATIONAL ADHESIVE INTESTINAL OBSTRUCTION
DOI:
https://doi.org/10.11603/2415-8798.2017.3.8068Keywords:
acute adhesive intestinal obstruction, endogenous intoxication, complication, postoperative period.Abstract
The problem of acute adhesive intestinal obstruction remains one of the most urgent and complicated in modern abdominal surgery. Among all types of obstruction, adhesive obstruction of the intestine occurs most often and ranges from 40.4 to 86 % of cases.
The aim of the study – to assess the level of endogenous intoxication in patients with adhesive obstruction before and after surgery and determine their effect on the development of complications in the postoperative period.
Materials and Methods. The article adduces the results of an examination of 57 patients with acute adhesive intestinal obstruction. Among them 26 patients were operated laparoscopically, in 31 – laparotomy was performed, followed by the elimination of obstruction. The study of the level of endogenous intoxication markers (mediumsmolecular peptides and determination of the erythrocytic index of intoxication) was performed prior to the operation and at the 3rd day of postoperative period.
Results and Discussion. It has been established that in patients with acute adhesive obstruction, the level of markers of endogenous intoxication significantly increases to the operation and the degree of growth of these indicators primarily depends on the stage of intestinal obstruction. In 3 days after the surgery, a slight decrease in the level of endogenous intoxication was revealed, indicating additional mechanisms of development of toxicosis after surgery.
Conclusions. During the study, we did not establish a significantly reliable relationship between markers of endogenous intoxication and the development of complications in the postoperative period. A close correlation was found between the time of recovery of the motor function of the intestines and the level of endogenous intoxication, which indicates the leading role of the intestine in the formation of toxicosis in patients with adhesive intestinal obstruction.
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