Drainage methods in patients with unformed intestinal fistulas during the preparation to the surgical treatment

Abstract

The aim of the study is to analyze the data of the modern foreign and domestic literature on intestinal fistulas, including high unformed small intestinal fistulas, their classification, treatment methods, drainage methods, their types and effectiveness. Research method: the search in the elibrary, CyberLeninka, PubMed and SpringerLink databases. Intestinal fistulas, often found in the surgical practice, appear due to a number of reasons (errors in the surgical technique and conservative treatment, tactical errors, the presence of severe concomitant diseases, etc.) and present a high-risk factor for death. Clinically, intestinal fistulas can differ depending on their localization, etiology, morphology, function, complications, etc., that causes certain difficulties in choosing the treatment method and reduces its success. Special attention is paid to high unformed small intestinal fistulas, which are accompanied by pronounced impairment of the body's homeostasis system, on the one hand, and the need for a multi-stage treatment, on the other hand. The treatment regimen for high unformed small intestinal fistulas includes both conservative and surgical approaches. The conservative method of treatment includes an intensive infusion therapy, control of the source of infectious complications, reduction of irretrievable losses, nutritional therapy, and a local treatment, which consists in protecting the tissues from the aggressive intestinal content and various methods of adequate drainage of the wound. The drainage methods used for intestinal fistulas differ depending on the principle of their operation, the surgical drain material, the configuration of the wound, the fistula morphology, the number of fistulas, etc. Active and vacuum methods seem to be used most frequently and efficiently in the local treatment of high unformed small intestinal fistulas. So far, according to the (very limited) modern literature, there has been a diversity in the effectiveness of the drainage treatment approaches in patients with high unformed small intestinal fistulas, thus, further studies are needed to study and evaluate their pathogenetic role and effectiveness.