Mametkulyyev B. Optimization results reconstructive operations for obstructive colon resection considering prevention of septic complications.

Thesis is devoted to improving the results of surgical treatment of patients when performing reconstructive operations after obstructive colon resection by preventing septic complications. The work was based the results of examination and treatment of 107 patients after resection of obstructive colon were in the clinic "Institute of General and Emergency Surgery them. V.T. Zaytseva NAMS of Ukraine", which constituted the bulk (52 patients) and control group (55 patients). Analysis of clinical data showed that reconstructive intervention after obstructive colon resection after radical surgery for cancer, it is permissible for 6 months after the first operation; at the stoma, imposed because of an injury of the colon - after two months; with colostomy imposed under purulent peritonitis - not earlier than 6 - 9 months. In poststomalnom department contains 3.7 times more anaerobes than prestomalnom. Revealed that prognostic criteria of septic complications in the postoperative period are the coefficients reflecting the balance in the system - proteinase inhibitor (cathepsin D / antitripticheskaya total activity of cathepsin D / Activity acid- inhibitors), and activity energy processes (acid phosphatase / alkaline phosphatase) in the peripheral blood plasma of patients. The proposed method is prolonged antibiotic therapy reduces the number of septic complications in the study group after reconstructive operations to 9.6 % compared with 18.2% in the comparison group by reducing the frequency of specific complications. Using the proposed ways to restore intestinal continuity after resection of obstructive colon allowed significantly improve treatment outcomes. The proposed integrated approach on a reconstructive intervention, prediction and prevention of suppurative complications at all stages of treatment, able to significantly improve their performance.