DEPENDENCE OF THE TREATMENT TACTICS OF THE PATIENTS WITH ACUTE COLONIC OBSTRUCTION ON THE ULTRASOUND RESEARCH RESULTS
About the author:
Tamm Т. I., Nepomnyaschy V. V., Barduck A. Ya.
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
The treatment results of the patients with ACO are unsatisfactory because of both high figures of post-operative complications (40-60%) and post-operative mortality up to 30-60%. Surgeons have not yet reaches consensus about treatment tactics of the patients with obstructive ileus because of their serious condition. The aim of the work is to set objective criteria among patients with ACO which determine the choice of the terms and volume of operative intrusion. Results. The results of the treatment of 168 patients with acute colonic obstruction having been in the hospital from 2014 to 2019 are presented in the work. There were 76 (45,2%) men, 92 (54,8%) women at the age from 37 to 85 years old. The patients over 60 were more than 65%. In 4-5 days from the beginning of the disease 85% of the patients were hospitalized with sub-compensated and decompensated clinical picture of acute colonic obstruction. The diagnosis of the disease was defined on the basis of anamnesis data, objective examination, clinic-biochemical marks, radiation research methods (USR and abdominal x-ray), rectoscopy and colonoscopy. Advantage of USR was demonstrated in sub-compensated and decompensated colonic obstruction diagnostics. The diagnostics and treatment tactics of the disease was based on USR data. The conservative therapy among patients with ACO was stated to be carried out in the absence of peritonitis signs and positive dynamics of local changes in the colon according to USR data, urgent operative intrusions in patients with ACO were carried out in presence of free fluid in the abdominal cavity and negative dynamics of ultrasound criteria from outside the intestine, degree of impaired bowel contractility determined with the help of USR is the criteria of the choice of intestine decompression method. Post-operative mortality was 11,9%. Ultrasound research method is not invasive, available and highly informative in diagnostics of colonic obstruction of tumor genesis.
acute colonic obstruction, ultrasound research, intestinal decompression, purulent complications.
- Rusin VI, Chobey SM, Rusin AV, Boldizhar OO, Ihnat VI. Tovstokyshkova neprokhidnistʹ pukhlynnoho henezu. Navchalʹno-metodychnyy posibnyk. Vydavnytstvo UzhNU «Hoverla»; 2010. s. 298. [in Ukrainian].
- Vorob’yev AI, Khalov YuN, Grishin KN. Ekstrennyye odnomomentnyye vmeshatel’stva pri rake levoy poloviny obodochnoy kishki. Vestnik khirurgicheskoy gastroenterologii. 2008;4:111-2. [in Russian].
- Boyko VV. Diahnostyka ta likuvannya khvorykh z hostroyu neprokhidnistyu kyshky. Kh.: KhNU imeni VN Karazina; 2014. 176 s. [in Ukrainian].
- Radzikhovskiy AP, redaktor. Belyayeva OA, Kolesnikov YeB. Neprokhodimost’ kishechnika: rukovodstvo dlya vrachey. K.: Feniks; 2012. 504 s. [in Russian].
- Ivanova YuV, Logachev VK. Mestnoye lecheniye posleoperatsionnykh gnoyno-vospalitel’nykh oslozhneniy. Kharkivska khirurhichna shkola. 2012;3(54):92-4. [in Russian].
- Tamm TI, Nepomyanshchiy VV, Dvornik IA, Bardyuk AYa, Yavorskaya TP, Ustinov AT. Vliyaniye metoda UZI na rezul’taty lecheniya bol’nykh ostroy kishechnoy neprokhodimosti. Kharkivska khirurhichna shkola. 2015;2(71):53-7. [in Russian].
- Sjo OH, Larsen S, Lunde OC. Short term outcome after emergency and elective surgery for colon cancer. Colorectal Dis. 2009;11(7):733-9.
- Tamm TI, Bardyuk OYa, Hvozdik YuA. Morfolohichni zminy u pryvidnomu viddili tonkoyi kyshky pry obturatsiyniy kyshkoviy neprokhidnosti. Acta medica Leopoliensia. 2008;3:119-22. [in Ukrainian].
- Uematsu D, Akiyama G, Magishi A. Laparoscopic Hartmann’s procedure for fecal peritonitis resulting from perforation of the left-sided colon in elderly and severely ill patients. Tech Coloproctol. 2012;16(3):243-6.
- Akiyoshi T, Fujimoto Y, Konishi T. Prognostic factors for survival after salvage surgery for locoregional recurrence of colon cancer. Am J Surg. 2011;201(6):726-33.
- Ansaloni L, Andersson RE, Bazzoli F. Guidelenines in the management of obstructing cancer of the left colon: consensus conference of the world society of emergency surgery (WSES) and peritoneum and surgery (PnS) society. World J Emerg Surg. 2010;5:29.
- Aslar AK, Ozdemir S, Mahmoudi H. Analysis of 230 cases of emergent surgery for obstructing colon cancer-lessons learned. J Gastrointest Surg. 2011;15(1):110-9.
- Bohun OA. Profilaktyka hniyno-septychnykh uskladnenʹ u khvorykh na hostru neprokhidnistʹ kyshechnyku [avtoreferat]. Kharkiv: 2010. 16 s. [in Ukrainian].
- Tamm TI, Nepomnyashchyy VV, Bardyuk OYa, Polyansʹkyy DP, vynakhidnyky. Sposib vyznachennya stupenya hostroyi kyshkovoyi neprokhidnosti. Patent Ukrayiny na korysnu modelʹ № 135032. 2019 Cherv 10. [in Ukrainian].
Publication of the article:
«Bulletin of problems biology and medicine» Issue 2 (156), 2020 year, 166-170 pages, index UDK 616.345-007.272-036.1-073.432.19-089