Efficiency of pre-operative preparation of intestines at treatment of sharp intestinal impassability tumoral genesis

Abstract

   Aim. To improve the results of surgical treatment of patients with acute intestinal obstruction of tumor genesis during radical surgery.   Material and methods. Results of observation and treatment of 31 patients with acute colonic obstruction of tumorous genesis at the age from 34 till 72 years are presented. The most frequently observed was rectosigmoidal location of the tumor. The study group included 14 patients (45,2 %), in the control group - 17 (54,8 %). For diagnostic purposes general clinical and biochemical blood tests, ultrasound, MRI, CT, colonoscopy, rectoromonoscopy and video laparoscopy when indicated as well as pathohistological examination of biopsy specimens, taken from macro preparations of removed celiac tumor were carried out.   Results and discussion. It was found out that more expressed decrease of inflammatory processes and intoxication indexes is observed in the patients of the main group, which were preoperatively prepared according to the method suggested in the clinic; early normalization of the laboratory and instrumental indexes in the postoperative period in comparison with the control group of patients, in which preoperative preparation was performed according to the traditional schemes. In 2 (11,8 %) cases of the control group patients suture inconsistency was revealed, in 3 (17,6 %) cases - purulence of the postoperative wound. In 1 case (5.9 %) lethal outcome was registered due to myocardial infarction. Inflammation of the postoperative wound was observed only in 1 (7,1 %) case among the main group patients.   Conclusion. Decompression of the upper section of the bowel loop in combination to enterosorption in the preoperative period is the effective method of the bowel preparation for the radical surgery and promotes to decrease the frequency of the early postoperative purulent-inflammatory complications.