RAILIANU S. Optimization of surgical treatment of patients with stranded hernias of the anterior abdominal wall, complicated by acute intestinal obstruction

he dissertation presents the results of surgical treatment of patients with entrained hernias of the anterior abdominal wall, complicated by acute intestinal obstruction, and specifies the indications and substantiates the choice of their optimal parameters in order to reduce the number of postoperative complications. The following surgical tactics were applied to these patients: splitting of the hernia, plastic of the hernia gate and, if necessary, drainage of the abdominal cavity were performed in patients of the first clinical group. Patients of the IIA subgroup after elimination of the cause of intestinal obstruction in the postoperative period were administered a gastric probe only for passive outflow of intestinal contents. Patients of the II B subgroup, after elimination of the cause of intestinal obstruction, intraoperatively performed nasogastric intubation of the intestine for lavage, oxygen therapy and enteral nutrition. Intestinal lavage was performed with 0.9% NaCl solution, enteral nutrition was started with the appearance of peristalsis (2-3 days postoperatively) with the help of "Peptamen" solution. In order to restore normal intestinal flora, a probiotic was added to the lumen of the small intestine (the contents of 2 capsules were dissolved in 100 ml of saline twice a day).