Bukata V. Оptimization of surgical treatment and prevention of development of acute adhesive obstruction of small gut.

The dissertation is devoted to the actual problem of surgery, in particular, the improvement of the results of complex treatment of patients with acute adherence of narrow-neck obstruction through the improvement of diagnostic and therapeutic tactics, the definition of factors that negatively affect the course of the disease and the development of methods for preventing the development of complications and recurrence of the adhesive process on the basis of clinical symptomatology analysis, the functional state of the microcirculation bed and the level of endogenous intoxication. The results of the study of the state of microcirculation, endogenous intoxication and temperature homeostasis in patients with acute adhesive intestinal obstruction, depending on the severity of the disease before surgery, intraoperative and postoperative period, are presented. Interrelations between the investigated parameters and the clinical course of the disease are analyzed. The main factors influencing the severity of the course of acute adherence of narrow-neck obstruction and the development of complications in the postoperative period are determined. The influence of the basic therapy of acute adherence of narrow-neck obstruction and treatment with the inclusion of the agent on the basis of amber acid and the local use of the barrier means of prevention of adhesion on the dynamics of clinical parameters, microcirculatory disturbances and endogenous intoxication markers was investigated. The use of this therapy allowed to accelerate the recovery of the motor-evacuation function of the intestine, to reduce the duration of the postoperative period and the absence of early adhesive obstruction in the main group of patients.