PREVENTION OF MOTOR-EVACUATION DISORDERS IN THE POSTOPERATIVE PERIOD AFTER SURGERY FOR ACUTE NON-TUMOR SMALL INTESTINAL OBSTRUCTION
O. Kh. Khalidov, V.S. Fomin
A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
Background. Postoperative motor-evacuation disorders play an important role and occupy a significant place in the structure of complications after abdominal surgery. Treatment of acute adhesive intestinal obstruction requires partial or total adhesiolysis in addition to direct restoration of the passage of chyme, which can become a springboard for motor disorders due to edema of the intestinal wall, peritoneal injury, the effect of denudation and the formation of new adhesions. Objective. The evaluation of the effectiveness of resonance electric stimulation in complex correction of motor-evacuation disorders in patients in the postoperative period after elimination of acute non-tumor small intestinal obstruction. Methods. 65 case histories of patients who were on inpatient treatment for the period 2015–2018 were subjected to analysis. The mean age was 53.4±3.7 years, gender distribution with a male predominance of 1.5:1. The groups were divided into the main group (n=33, standard management in the postoperative period with additional application of resonance electric stimulation) and the comparison group (n=32; standard postoperative management of patients). The groups were completely matched by sex, age, extent of operation, severity of the condition (p≤0.05). Patients underwent surgery for non-tumor intestinal obstruction with laparotomy access. Results. Against the background of resonance stimulation, a faster recovery effect of motor-evacuation function of the intestine was noted in the main group. Complete restoration of the digestive tract function in the main group was noted at 5 days of treatment in 33 (100%) patients, which significantly differed from the identical parameters of the comparison group (n=26, 81.25%, p≤0.05). Complications according to the Dindo D. et al. scale: in the comparison group 7 (21.9%, p≤0.05) cases of intestinal paresis, in the main group this complication was not registered. The duration of postoperative hospital treatment was significantly longer in the comparison group (9.3±1.3 days) than in the main group (6.2±0.8 days, p≤0.05). Conclusion. The use of resonance electric stimulation in the complex management of the postoperative period promotes faster normalization of peristalsis, restoration of passage of intestinal contents through the digestive tract, early normalization of intraperitoneal hypertension, and prevention of multiple organ failure.
Keywords: non-tumor intestinal obstruction, postoperative paresis, resonance electrical stimulation
About the Autors
Corresponding author: V.S. Fomin – PhD in Medical Sciences, Associate Professor at the Department of Surgical Diseases and Clinical Angiology, MSMSU n.a. A.I. Yevdokimov, Moscow, Russia; e-mail: firstname.lastname@example.org, ORCID: https://orcid.org/0000-0002-1594-4704