Byck P. Prophylaxis and treatment of peritoneal adhesive disease during open abdominal surgery with alimentary canal opening

The aim of the dissertation is to improve treatment and prophylaxis outcomes for peritoneal adhesive disease for open abdominal surgery with alimentary canal opening by experimental and clinical study of differentiated approach considering adhesive process characteristics, place of alimentary canal opening, the presence of peritonitis and intestinal obstruction. The work analyzes the results of experimental study of 96 rats with intestinal anastomoses and142 patients with peritoneal adhesive disease after surgery with alimentary tract opening. In the course of the experiment, the main characteristics of the adhesive process during opening of different intestinal parts were revealed, anti-adhesive gel efficiency and its effect on infectious and inflammatory complications were studied, and the new tactical approaches for patients' treatment were proved. The developed treatment and prophylaxis algorithms for peritoneal adhesive disease were applied to 65 patients and yielded reduction of the infectious and inflammatory complications rate from 44.2 % to 26.2 % in early postoperative period; the number of re-hospitalized and re-operated patients with adhesive intestinal obstruction reduced from 22.1 % to 9.2 % and from 13.0 % to 3.1 % respectively (all p<0.05) during the 2-year observation period.