Galyuk V. Method selection of the surgical treatment for the patients with acute adhesive intestinal obstruction together with ventral hernia

Object - acute adhesive intestinal obstruction combined with ventral hernia; purpose - to develop a methodology complex surgical treatment methodology of patients with acute adhesive intestinal obstruction combined with ventral hernia, taking into account the functional state of liver, hemodynamic features of liver and kidney in intra-abdominal hypertension; methods - general clinical, laboratory, instrumental, spectrometric and statistically analytic; results - in 128 patients the clinical manifestations of acute adhesive intestinal obstruction and ventral hernia and their correlation with ultrasonographic and radiographic data, protein synthesizing indicators of liver function, intra-abdominal hypertension syndrome, changes in hepatic-renal perfusion were studied; that allowed to develop the optimal surgical tactics; it was determined that the most common cause of acute adhesive intestinal obstruction is surgical intervention in acute surgical pathology, which in 53.1% of patients was combined with postoperative ventral hernias, the development of acute adhesive intestinal obstruction is characterized by serum protein fractions dysproteinemia with the decrease of total protein level , increase of trasferyn, ceruloplasmin depth of which depended on the duration of the disease, intra-abdominal hypertension syndrome leads to severe hepatic-renal hypoxia, to minimize the impact of intra-abdominal hypertension and to prevent the development of hepatic-renal dysfunction the choice of plastic meshed graft in-lay can be used; it was determined that the performance of urgent surgery without adequate preoperative preparation the frequency of postoperative complications is 8.9% and postoperative mortality is 2.3%.