Benedykt V. Clinical and pathogenetic substantiation of medical tactics at the stages of surgical treatment of patients with acute obstruction of the small bowel.

Dissertation is dedicated to the improvement of the results of surgical treatment of patients with acute small bowel obstruction using theoretical generalization and a new solution of the scientific problem consisting in the experimental pathogenetic substantiation of the development of dynamic obstruction of the small bowel in the postoperative period after the elimination of its mechanical obstruction, as well as the development and introduction of new and improving existing decompressing surgical and medical methods of enhancement of adaptive-compensatory processes in intestines for prevention and treatment of motor and evacuation disorders of the digestive canal in the intraoperative and postoperative periods. On the basis of the data obtained in the experiment, morphological and functional violations revealed that before and after the elimination of mechanical obstruction of the small bowel, dynamic obstruction evolved as a result of calcium ion deficiency, energy hunger with pronounced oxidative stress, disorder in localized immune resistance and structural disorganization on the subcellular, cellular and tissue levels in the wall of the small intestine, which causes the expressed paresis of the digestive canal in the early postoperative period. On the basis of these data a complex of medical and operational measures has been developed that allowed to effectively deal with the manifestations of dynamic obstruction in the early postoperative period, which led to accelerated recovery of the motor and evacuation function of the digestive canal after 2–3 days of surgical treatment, a decrease in the number of purulent septic wounds and respiratory complications, reduction of terms of inpatient treatment of patients for almost 5 days.