Yevtushenko D. Clinic - morphological substantiation of preventive and surgical treatment of patients with adhesive disease of the peritoneum and its complications.

This thesis presents the results of the study 598 patients with adhesive disease of the peritoneum. According to the results of the work showed that the presence of diploid and haploid point mutations of the gene integrin ITGA 2 polymorphism histocompatibility leukocyte antigen class 1 - HLA A9, A33, V56, V13 patients adhesive disease of the peritoneum, are the genomic risk factors for adhesive disease of the peritoneum. Epigenetic factors associated with the risk of adhesive disease of the peritoneum, are increasing the concentration of acute phase proteins - ceruloplasmin, haptoglobin, C-reactive protein, C3 fragment proteins of the complement system, changes in gene expression of adhesion molecules (CD31 increased by 10%, CD54 increased to 24, 1%), and the presence of antibodies to collagen, elastin, small intestine and colon. The efficiency mininvasive intervention methods and techniques of recovery operations in the intestine combined with antiadhesive agents which inhibit proliferation of connective tissue in the form of adhesions. Methods for the formation of intestinal anastomosis, methods of treating patients with adhesive disease of the peritoneum using mininvasive technology, a method of treatment of adhesive conglomerates way of antegrade intubation of the small intestine. Based on these data we developed a set of forecasting, prevention, comprehensive individualized surgical approach in the surgical treatment of patients with adhesive disease of the peritoneum, which significantly reduced the incidence of postoperative complications and improve remote results of treatment.