Previous Next

ARCHIVE

№3' 2020

SURGERY

International Medical Journal, Vol. 26., Iss. 3, 2020, P. 14−17.

DOI (https://doi.org/10.37436/2308-5274-2020-3-3)

USE OF ENTEROSORPTION TO PREVENT ENDOTOXEMIA IN ACUTE INTESTINAL OBSTRUCTION

V. T. Zaitsev Institute of General and Emergency Surgery, National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
Kharkiv National Medical University
Kharkiv Medical Academy of Postgraduate Education

The relevance of studying the measures to prevent the development of endotoxemia in acute intestinal obstruction is stipulated with an increasing incidence of multiple organ failure in debilitated patients and infectious−toxic shock. The development of endotoxemia is often accompanied with a secondary infection. Toxic effects of bacteria in small intestine, the trigger of which is their translocation and transformation of the small intestine into a focus of microbial invasion, prolongs the postoperative period, which increases the length of stay in the surgical hospital. Much attention is paid to the pathogenesis of the development of small bowel contamination syndrome, which results in changes in intestinal biocenosis and increased intoxication of the body, which worsens the patient general condition. To examine the results of entersorption as a method of detoxification and control of infectious and toxic complications in the patients with an acute intestinal obstruction before surgery to optimize surgical tactics and prevent post−surgery complications, a study was conducted in 36 patients with different stages of the disease. The effectiveness of detoxification in the combined treatment of an acute intestinal obstruction has been confirmed, which is indicated by the reduced pain, regression of radiological signs of obstruction in the patients and early normalization of their main clinical, laboratory and instrumental parameters. The use of the method of enterosorption as part of a comprehensive approach in the period after surgery contributed to the early restoration of intestinal motility, reducing the number of complications, improving the general condition of patients. Thus, the method of enterosorption is one of the most effective of modern detoxification methods, which determines its relevance and further prospects to study this problem.

Key words: acute intestinal obstruction, endotoxemia, enterosorption.

REFERENCES

1. Analiz lecheniya ostroi spaechnoi kishechnoi neprokhodimosti / V. V. Boiko i dr. // Kharkіvs'ka khіrurgіchna shkola. 2013. № 5 (62). S 5−7.

2. Biomarkers predicting sepsis in polytrauma patients: Current evidence / V. Ciriello et al. // Injury. 2013. Vol. 44, № 12. P. 1680−1692. doi: https://doi.org/10.1016/j.injury.2013.09.024

3. The nasojejunal tube in early postoperative nutrition / E. Monteferrante et al. // Minerva Chir. 2018. Vol. 54, № 7/8. P. 551−555.

4. Pіslyaoperatsіine lіkuvannya khvorikh na gostru spaikovu kishkovu neprokhіdnіst' / V. Ya. Pak, V. V. Leonov, V. Z. Mikitin, L. G. Kashchenko // Kharkіvs'ka khіrurgіchna shkola. 2015. № 2 (71). S. 74−78.

5. Daurea A. De−Souza, Lewis J. Greene. Intestinal permeability and systemic infections in the critical care patients. Effects of glutamine // Critical. Care Med. 2005. Vol. 33, № 5. P. 1125−1135. doi: https://doi.org/10.1097/01.ccm.0000162680.52397.97

6. Level of bacterium translocation biomarker at experimental compartment syndrome / E. Turgunov et al. // European Congress of Clinical Microbiology and Infectious Diseases. 2017. Session: P21, Category: 9b. Host−pathogen interaction.

7. Ursova N. I. Mesto enterosorbentov v terapii sindroma endogennoi intoksikatsii // Voprosy sovremennoi pediatrii. 2012. T. 11, № 6. S. 26−31.

8. Khіrurgіchna taktika lіkuvannya khvorikh na kolorektal'nii rak, shcho uskladnenii gostroyu obturatsіinoyu kishkovoyu neprokhіdnіstyu / Є. D. Khvorostov ta іn. // Galits'kii lіkars'kii vіsn. 2016. T 23 (№ 3, ch. 3). S. 86−88.

9. Chowdry S. M., Vaishnavi C. Spontaneous bacterial peritonitis. Infections of the Gastrointestinal System. New Delhi: Jaypee Brothers Medical Publishers. 2013. R. 532−542. doi: https://doi.org/10.5005/jp/books/11918_40

10. Laparoscopic management of recurrent adhesive small−bowel obstruction: Long−term follow−up / Q. Wang et al. // Surg. Today. 2009. Vol. 39, № 6. P. 493−499. doi: https://doi.org/10.1007/s00595−008−3906−4

11. Inadequate Clearance of Translocated Bacterial Products in HIV−Infected Humanized Mice / U. Hofer et al. // PLoS Pathogens. 2010. Vol. 6. P. 1−10.

12. Abdominal compartment syndrome / N. A. Stassen, J. K. Lukan, M. S. Dixon, E. H. Carrillo // Scandinavian J. of Surgery. 2002. Vol. 91. P. 104−108. doi: https://doi.org/10.1177/145749690209100116

13. Early operation is associated with a survival benefit for patients with adhesive bowel obstruction / P. G. Teixeira et al. // Annals of Surgery. 2013. Vol. 258, № 3. P. 459−465.

14. Microscopy of bacterial translocation during small bowel obstruction and ischemia in vivo − a new animal model / S. Samell et al. // BMC surgery. 2002. Vol. 2, № 6. P. 39−44.

15. Small Intestinal Bacterial Overgrowth / E. Grace et al. // Aliment. Pharmacol. Ther. 2013. Vol. 38, № 7. P. 674−688. doi: https://doi.org/10.1111/apt.12456

16. Changing management and survival in patients with stage IV colorectal cancer / C. Platell et al. // Dis. Colon. Rectum. 2018. Vol. 54, № 2. P. 214−219. doi: https://doi.org/10.1007/dcr.0b013e3182023bb0