DOI: 10.25881/20728255_2022_17_1_41

Authors

Gulov M.K., Safarov B.I., Ruziboyzoda K.R.

Avicenna Tajik State Medical University, Tajikistan, Dushanbe

Abstract

Purpose. Improving the results of complex treatment of acute adhesive small bowel obstruction.

Material and methods. The results of complex treatment of 50 patients with acute adhesive small bowel obstruction are presented. In 46 (92%) observations out of 50 (100%) patients, the causes of acute adhesive small bowel obstruction were various pathologies of the abdominal organs, which in the anamnesis underwent surgical interventions of various nature and volume, and in 4 (8%) cases it arose primarily, without performing surgical interventions.

Results. Patients with acute adhesive small bowel obstruction (n = 50) in 30 (60%) cases in the presence of a single cicatricial band and a local adhesive process underwent videolaparoscopic adhesiolysis with drainage of the abdominal cavity. In 13 (26%) cases with limited non-extended intestinal necrosis with hemorrhagic peritonitis, videolaparoscopic-assisted adhesiolysis, resection of the small intestine with side-to-side anastomosis with drainage of the abdominal cavity were performed. In 7 (14%) cases, during diagnostic laparoscopy, the presence of a widespread adhesive process, gross cicatricial changes and intestinal necrosis of more than 20 cm with the presence of widespread purulent-fibrous peritonitis was stated, in which access conversion was performed — laparotomy followed by total adhesiolysis. In the early postoperative period, complex pathogenetic conservative therapy was carried out, including the use of serotonin adipate 1.0 ml 3 times a day, mexidol 2.0 intravenously 2 times a day, tivortin 100.0 ml intravenously 1 time per day, as well as the drug enoxatil, 0.6 ml s / c 1 time per day for 5–7 days.

Conclusion. To restore the motor-evacuation function of the small intestine and prevent the risk of recurrence of adhesive intestinal obstruction, along with laparoscopic adhesiolysis, it is necessary to carry out complex pathogenetic treatment with the inclusion of an antioxidant and antihypoxant, serotonin adipinate and enoxatil.

Keywords: аcute intestinal obstruction, adhesive disease, pro-inflammatory cytokines, serotonin, complex treatment.

References

1. Altiev BK, Atadzhanov ShK, Isabaev ShB. Problems of diagnosis and treatment of acute adhesive intestinal obstruction. Vestnik Emergency honey. 2010; 1: 88-92. (In Russ).

2. Boimurodov OS, Yorov YB, Gaziev ZKh, Toshev ShA. A case of successful treatment of acute adhesive small bowel obstruction using minimally invasive technology. Aviсennа Bulletin. 2017; 4: 556-570. (In Russ).

3. Khadzhibaev AM, Khodzhimuhamedova NA, Khadzhibaev FA. Diagnosis and treatment of intestinal obstruction. Kazan medical journal. 2013; 94(3): 377-381. (In Russ).

4. Stepanyuk A.A. Diagnostics, treatment and prevention of adhesive intestinal obstruction. Extr. the medicine. 2012; 2: 113-122. (In Russ).

5. Meier RP, de Saussure WO, Orci LA. Clinical outcome in acute small bowel obstruction after surgical or conservative management. World J. Surg. 2014; 38(12): 3082-3088.

6. Kurbonov KM, Nazirboev KR, Yorov SK. Correction of the syndrome of enteric insufficiency in patients with widespread peritonitis. Postgraduate education bulletin in health care. 2017, 1: 38-42. (In Russ).

7. Byrne J, Saleh F, Ambrosini L, Quereshy F, Jackson TD, Okrainec A. Laparoscopic versus open surgical management of adhesive small bowel obstruction: a comparison of outcomes. Surg. Endosc. 2015; 29: 2525-2532.

8. Kurbonov KM, Nazirboyev KR, Daminova NM. Intubation of the small intestine as a component of the treatment of acute strangulated small bowel obstruction. Aviсennа Bulletin. 2018; 20(4): 436-441. (In Russ).

9. Stepanyuk AA, Zavada NV. Long-term results of surgical treatment of patients with acute adhesive intestinal obstruction. Surgery. East Europe. 2016; 1: 17-23. (In Russ).

10. Lutsevich OE, Gallyamov EA, Popov SV. Features of laparoscopic operations in conditions of peritoneal adhesive disease and the possibility of its laparoscopic treatment and prevention. Pacific Medical Journal. 2017; 1(67): 69-73. (In Russ).

For citation

Gulov M.K., Safarov B.I., Ruziboyzoda K.R. Complex treatment of acute adhesive small bowel obstruction. Bulletin of Pirogov National Medical & Surgical Center. 2022;17(1):41-44. (In Russ.) https://doi.org/10.25881/20728255_2022_17_1_41