Features of contamination processes of some vascular collectors in patients with strangulated abdominal hernias complicated by acute intestinal obstruction

March 20, 2023
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The aim is to investigate the peculiarities of contamination processes of individual vascular collectors in patients with strangulated abdominal hernias complicated by acute intestinal obstruction during intraoperative intestinocorrection.

Object and methods of the research. The paper analyzes the results of surgical treatment of 194 patients with strangulated abdominal hernias complicated by acute intestinal obstruction. Depending on the peculiarities of intraoperative integument correction, patients were divided into two groups: 1st (n= 94) — group of comparison and 2nd (n=100) — the main group. In patients of 1st group, intraoperative intestinocorrection was performed using a Miller — Abbott probe with the use of an iso-intestinal mixture. In patients of 2nd group, a priority three-channel probe was used and a comprehensive systemic-regional intraoperative intestinocorrection was performed.

Results. The use of complex systemic-regional intraoperative integumentary correction in patients of 2nd group, in contrast to 1st group, 30 minutes after its completion is characterized by a significant decrease in v. subclavia sinister medium mass molecules (MMM-254) to 0.51±0.03 units, leukocyte index of intoxication to 3.59±0.32 units, and conjugated diene to 5.24±0.51 units/mg lipids, malondialdehyde to 5.52±0.49 nmol/ml and an increase in catalase to 4.47±0.35 mmol H2O2/min/mg Hb and superoxide dismutase to 5.23±0.67 units/mg Hb. In patients of 2nd group, a decrease in the aggressiveness of contamination processes in the integumentary portal vascular collector was also found, which was reflected in a decrease in MMM-254 to 0.64±0.05 units, leukocyte index of intoxication to 3.86±0.45 units, and conjugated diene to 5.62±0.54 units/mg lipids, malondialdehyde to 5.85±0.49 nmol/ml and an increase in catalase to 4.14±0.34 mmol H2O2/min/mg Hb and superoxide dismutase to 4.92±0.46 units/mg Hb.

Conclusions.Intraoperative intubation of the small intestine and intestinosanation in patients with strangulated abdominal hernia complicated by acute intestinal obstruction is accompanied by a significant increase in intoxication factors in both the lymphatic and portal blood flow. The use of complex systemic-regional intraoperative intestinal correction in patients of the main group reduced the negative manifestations of dislocation processes and contributed to the preservation of compensatory reserves of the intestine, accompanied by the weakening of integumentary-lymphatic and integumentary-portal contamination dislocation — a leading factor in the development of multiorgan failure and irreversible generalization of the pathological process.

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