scholarly journals EXPERIENCE OF STAGED SURGICAL TREATMENT OF ACUTE OBSTRUCTIVE INTESTINAL OBSTRUCTION OF TUMOR ORIGIN

2021 ◽  
pp. 37-41
Author(s):  
M. A. Kashtalyan ◽  
V. Y. Shapovalov ◽  
R. V. Yenin ◽  
M. О. Koshicov ◽  
S. O. Pasternachenko
Keyword(s):  
Surgical Treatment ◽  
Elderly Patients ◽  
Intestinal Obstruction ◽  
Stent Placement ◽  
Colonic Obstruction ◽  
Vital Signs ◽  
Acute Intestinal Obstruction ◽  
Clinical Center ◽  
Tumor Origin ◽  
The Military

Summary. Objective: to improve the results of surgical treatment of patients with acute intestinal obstruction of tumor origin. Materials and methods of research. During the period from 2014 to 2020 in the surgical clinics of the Military Medical Clinical Center of the Southern Region (Odessa) 186 patients were treated with acute obstructive colonic obstruction of tumor origin. Research results and their discussion. In 34 (18.3 %) patients with GOKN during the applied conservative measures positive dynamics was observed, which allowed to examine patients in detail and prepare for surgery. In 6 (3.2 %) elderly patients with severe comorbidities, tumor recanalization and stent placement were performed. In 146 (78.5 %) patients, conservative measures were unsuccessful and were operated on according to vital signs, the first stage of which was intestinal fatigue. Conclusions. Step-by-step tactics of surgical treatment of acute intestinal obstruction of tumor origin with the use of laparoscopic colostomy in the first stage were used in 60.3 % of patients, which allowed final verification of the diagnosis, safe compensation of electrolyte and nutritional disorders in the patient and further treatment and correction.

scholarly journals Experimental substantiation of using a synthetic peptide in the complex surgical treatment of acute intestinal obstruction

2018 ◽  
pp. 138-140
Author(s):  
А.А. Коваленко ◽  
В.К. Хугаева
Keyword(s):  
Surgical Treatment ◽  
Intestinal Obstruction ◽  
Intestinal Anastomosis ◽  
Intestinal Wall ◽  
Acute Intestinal Obstruction ◽  
Study Objective ◽  
Doppler Flowmetry ◽  
Study Results ◽  
Small Intestinal

Высокая смертность при хирургическом лечении острой кишечной непроходимости (ОКН) определила поиск новых методов сопутствующей терапии. Обнаруженная ранее высокая эффективность опиоидных пептидов в стимулировании лимфотока в микрососудах брыжейки тонкой кишки у крыс, восстановлении нарушенной микроциркуляцию и снижении смертности при ряде заболеваний, определила цель данного исследования: изучить роль фармакологической стимуляции лимфотока в динамике ОКН. В работе использовали методы: биомикроскопия, лазерная допплеровская флоуметрия брыжейки и стенки тонкой кишки крысы, регистрация сократительной активности лимфатических микрососудов ЛМ методом фотометрии, морфометрия микрососудов, видео- и фотосъемка. Полученные результаты предполагают наличие адаптационной роли у активатора микролимфоциркуляции (опиоидного пептида-171 прямого действия) в комплексном хирургическом лечении ОКН. Однократное орошение пептидом межкишечного анастомоза (после удаления) и поврежденного лигатурой фрагмента кишки (перед зашиванием операционной раны) увеличивало выживаемость животных с ОКН на 23%. У всех выживших животных отмечено восстановление: проходимости кишки, микроциркуляции в кровеносных и лимфатических микрососудах, а также структуры стенки кишки. High mortality in the surgical treatment of acute intestinal obstruction (AIO) has warranted the search for new methods of concomitant therapy. Opioid peptides have proved highly effective in stimulating the lymphatic flow in rat small intestinal mesenteric microvessels, restoring the impaired microcirculation, and reducing mortality in many diseases. This had determined this study objective: to investigate the role of lymphatic stimulation in the dynamics of AIO. The study used methods of biomicroscopy, laser Doppler flowmetry, and histological examination of the mesentery and the small intestinal wall in rats; recording the contractile activity of lymphatic microvessels using photometry; microvessel morphometry; video and photography. The study results suggested an adaptive role of the lymphatic microcirculation activator (direct-action opioid-171) in the complex surgical treatment of AIO. A one-time peptide irrigation of the intestinal anastomosis (after removal) and the intestinal injuried by the ligature (before the surgical wound was sutured) increased the survival of animals with AIO by 23%. In all surviving animals, recovery of the intestinal patency, blood and lymphatic microcirculation, and the intestinal wall structure was observed.

IMPROVEMENT OF DIAGNOSTICS AND TACTICS OF TREATMENT OF PATIENTS OF ELDERLY AND SENILE AGE WITH ACUTE OBTURATIONAL PULPOSITIONAL OBSTACLE OF TUMOR GENESIS

2021 ◽  
pp. 908-915
Author(s):  
Н. И. Глушков ◽  
М. Ю. Кабанов ◽  
Т. Л. Горшенин ◽  
К. В. Семенцов ◽  
М. Ю. Лобанов ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Abdominal Aorta ◽  
Postoperative Mortality ◽  
Acute Intestinal Obstruction ◽  
Diagnostic Methods ◽  
Abdominal Pressure ◽  
Hemodynamic Parameters ◽  
Surgical Interventions ◽  
Tumor Origin ◽  
Visceral Arteries

Проанализированы результаты оказания помощи 346 больным пожилого и старческого возраста с острой обтурационной кишечной непроходимостью опухолевого генеза. В диагностике острой кишечной непроходимости, наряду с традиционными методами диагностики, оценивали динамику внутрибрюшного давления и показатели гемодинамики в висцеральных артериях брюшной аорты. На основании проведенного обследования было показано, что острая обтурационная кишечная непроходимость сопровождается повышением внутрибрюшного давления и редукцией кровотока в висцеральных артериях брюшной аорты, причем чем больше степень кишечной непроходимости, тем более выражены эти изменения. Использование этих исследований позволило усовершенствовать диагностику острой кишечной непроходимости опухолевого генеза. Кроме того, оценка этих показателей в динамике свидетельствовала об эффективности проводимых консервативных мер и давала основание более своевременно устанавливать показания для выполнения хирургического вмешательства. Комплексный подход в своевременной диагностике острой кишечной непроходимости опухолевого генеза позволил выделить группу больных, которым возможно выполнение оперативных вмешательств с помощью эндовидеохирургических технологий. Использование малоинвазивных технологий в лечении рака ободочной кишки, осложненного острой кишечной непроходимостью, позволило снизить число послеоперационных осложнений и уровень послеоперационной летальности. The results of providing care to 346 elderly and senile patients with acute obstructive intestinal obstruction of tumor Genesis were analyzed. In the diagnosis of acute intestinal obstruction, along with traditional diagnostic methods, the dynamics of intra-abdominal pressure and hemodynamic parameters in the visceral arteries of the abdominal aorta were evaluated. Based on the study, it was shown that acute obstructive intestinal obstruction is accompanied by an increase in intra-abdominal pressure and a reduction in blood flow in the visceral arteries of the abdominal aorta. Moreover, the greater the degree of intestinal obstruction, the more pronounced these changes are. The use of these studies made it possible to improve the diagnosis of acute intestinal obstruction of tumor Genesis. In addition, the assessment of these indicators in the dynamics indicated the effectiveness of conservative measures and gave reason to establish more timely indications for performing surgery. A comprehensive approach to timely diagnosis of acute intestinal obstruction of tumor origin allowed us to identify a group of patients who can perform surgical interventions using endovideosurgical technologies. The use of minimally invasive technologies in the treatment of colon cancer complicated by acute intestinal obstruction has reduced the number of postoperative complications and the level of postoperative mortality.

scholarly journals Bowel decompression in the treatment of patients with acute colonic obstruction

2019 ◽  
Vol 23 (3) ◽  
pp. 420-424 ◽  
Author(s):  
V.V. Nepomniashchyi
Keyword(s):  
Motor Activity ◽  
Intestinal Obstruction ◽  
Motor Function ◽  
Colonic Obstruction ◽  
Acute Intestinal Obstruction ◽  
Intestinal Lumen ◽  
Intestinal Intubation ◽  
Number Of Patients ◽  
Intestinal Decompression ◽  
Medical Histories

According to literature data acute intestinal obstruction is characterized by a great number of neglected forms comprising 5–70% cases with the given pathology. A number of radiological signs in the way of Kloiber’s bowls and intestinal arches simply confirm this and testify of colon motor activity decompensation. To date there are no objective diagnostic criteria providing indications to intestinal decompression before the operation. Intestinal intubation, its types and indications to its fulfilment are based only on the experience and intuition of the operating surgeon. Aim — to define clinical efficiency of the intestinal wall impaired contractility diagnostics method in the treatment of patients with acute colonic obstruction. Medical histories analysis of 166 patients with obstructive intestinal obstruction was carried out. Assessment of intestinal motor activity compensation was carried out with the help of echographic criteria — the number of enlarged small bowel loops, intestinal lumen width, wall thickness, distance between Kerckring folds, number of peristaltic movements per minute. According to the suggested method 3 groups of patients were distinguished — with compensated motor activity (32 (19%) patients), with sub-compensated motor activity (61 (36.5%) patients) and with intestinal decompensated motor activity (73 (44.4%) patients). Wherein the greater number of patients with obstructive ileus (135 (81%) patients) got into the hospital with sub- and decompensated intestinal motor function. In the group of patients with compensated muscular tone intestinal decompression was not carried out, in the second group with sub-compensated intestinal tone decompression was carried out simultaneously in 13 (7.8%) patients, and in 9 (5.4%) a nasojunal probe was installed for 2–3 days, in the third group intestinal intubation was done in 63 (38%) patients. Post-operative mortality was 3.2%. Thus, echographic criteria allow establishing the degree of intestinal impaired motor function before the operation in patients with acute intestinal obstruction which decompression depends upon its state.

scholarly journals Diagnosis and surgical treatment of acute intestinal obstruction caused by extragenital form of endometriosis

2020 ◽  
Vol 12 (1) ◽  
pp. 97-101
Author(s):  
Zemlyanoy V. Р. P. Zemlyanoy ◽  
B. V. Sigua ◽  
D. S. Syomin ◽  
D. V. Gurzhiy ◽  
D. H. Qalandarova
Keyword(s):  
Surgical Treatment ◽  
Gastrointestinal Tract ◽  
Intestinal Obstruction ◽  
Sigmoid Colon ◽  
Clinical Laboratory ◽  
Acute Intestinal Obstruction ◽  
Intestinal Lumen ◽  
Childbearing Age ◽  
Surgical Department ◽  
Extragenital Endometriosis

Damage to the gastrointestinal tract with extragenital endometriosis is a very rare pathology. According to the literature, the frequency of damage to the gastrointestinal tract in endometriosis, after previously performed gynecological operations, is less than 1%. At the same time, involvement in the pathological process of the intestine is noted in 337% of women of childbearing age with diagnosed genital endometriosis. In most clinical cases extragenital endometriosis occurs intraoperatively due to the complexity of early diagnosis. This article presents a clinical case of successful surgical treatment of a 43-year-old patient admitted to a surgical department with signs of intestinal obstruction. According to the anamnesis the patient had been suffering from recurrent pains in the lower abdomen in the right mesogastrium and constipation. The day before hospitalization, the above mentioned symptoms become worse with additional nausea, vomiting, lack of gases and feces. Based on the clinical laboratory and instrumental data the diagnosis of acute intestinal obstruction was established; and the urgent surgical treatment was carried out. Two formations were revealed intraoperatively (in the terminal ileum and in the elongated loop of the sigmoid colon). Both formations circularly narrowed the intestinal lumen, however the ileum was the cause of obstruction. Due to the lack of histological verification and the inability to exclude the malignant nature of the formation, the surgical treatment was carried out taking into account oncological standard in the amount of ileum resection and obstructive resection of the sigmoid colon with lymphadenectomy and small intestine intubation. Pathohistological examination confirmed intestinal endometriosis. The course of the postoperative period revealed no complications. The patient was discharged on the 12th day for outpatient treatment under the supervision of a surgeon and a gynecologist at the place of residence with recommendations and subsequent planned hospitalization in order to conduct reconstructive surgery to restore intestinal patency.

The surgical treatment of patients with colorectal cancer with metastases in the next organs and tissues

2016 ◽  
Vol 10 (1) ◽  
pp. 0-0
Author(s):  
Тананян ◽  
A. Tananyan
Keyword(s):  
Colorectal Cancer ◽  
Surgical Treatment ◽  
Intestinal Obstruction ◽  
Colonic Obstruction ◽  
Long Term Results ◽  
Electrolyte Balance ◽  
En Bloc ◽  
Septic Complications ◽  
Water And Electrolyte Balance

The article presents the results of a comprehensive approach in the surgical treatment of patients with colorectal cancer complicated by acute or partial intestinal obstruction and metastases in the next organs and tissues. In cases of acute intestinal obstruction, surgery was carried out in the first 2-4 hours after admission for treatment at the clinic, according to the indications of observation in the hospital, at different times after admission to hospital in a planned manner. In the surgical treatment of colorectal cancer with metastasis to nearby lymph nodes and adjacent organs and tissues, single-stage surgery was performed to remove the tumor en bloc together with sites metastatic organs and tissues. During the period of post-operative rehabilitation of all patients received appropriate intensive rehabilitation treatment aimed at prevention of septic complications, using antibacterial drugs, with the restoration and normalization of water and electrolyte balance, and protein, the active maintenance of the functions of vital organs and systems. Treatment of colorectal cancer complicated by colonic obstruction and metastases, with differentiated approach can serve as prevention of probability of a favorable outcome of the immediate and long-term results.

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