A . Surgical tactics and treatment of patients with fistulas of thin bowel (clinical-experimental research)

The thesis is devoted to the optimization of the surgical treatment of patients with the unformed external fistulas of the small intestine (UEFSI) with the devices through the use of the temporary restoration of intestinal passage in order to correct the enteral syndrome. Developed surgical technique, and diagnostic and treatment algorithm for the correction of the enteral syndrome in patients with UEFSI, improvements to existing and developed new original methods of surgical treatment of patients with UEFSI. Studied the causes of adverse outcomes of fistulas of the small intestine, the technique of determining the effectiveness of structures obturators with the original stend device that allows you to simulate the main types of topographic relations of parts of the intestine and the wound defect. Developed in the experiment new and improved well-known device for temporary obturation UEFSI based on their morphometric characteristics, experimentally proved the feasibility of using devices for the temporary restoration of intestinal passage. The dynamics of hemostatic and patients on the basis of the data correction algorithm developed therapeutic enteral syndrome in UEFSI, analyzed the results of original and traditional treatments. Application of the developed surgical treatment of patients with UEFSI through the use of temporary devices restore intestinal passage in order to correct the enteral syndrome, possible to increase the efficiency of the method from 47.4% to 85.3%, to reduce the number of postoperative complications from 39.6% to 14.6%, to reduce postoperative mortality from 23,7% tо 14,7%.