[Optimization of early postoperative period in intestinal resection surgery for acute intestinal obstruction complicated by peritonitis]. / Optimizatsiya rannego posleoperatsionnogo perioda v rezektsionnoi khirurgii kishechnika pri ostroi kishechnoi neprokhodimosti, oslozhnennoi peritonitom.

ABSTRACT

OBJECTIVE: To establish the effectiveness of complex therapy with Remaxol in optimizing the early postoperative period and increasing the reparative ability of intestinal tissues in acute intestinal obstruction complicated by peritonitis. MATERIAL AND METHODS: We analyzed treatment outcomes in 37 patients with acute intestinal obstruction complicated by peritonitis. The control group included 19 patients who underwent standard therapeutic measures after resolving intestinal obstruction and resection of small or large intestine. The main group consisted of 18 patients who underwent intraoperative intestinal lavage with Remaxol through a probe and early postoperative intravenous infusions (800 ml within 2 days and 400 ml for subsequent 3 days). RESULTS: The main group was characterized by positive dynamics of clinical and laboratory parameters, in particular, relief of endogenous intoxication syndrome, reduction of oxidative stress and phospholipase activity, general hypoxia. Postoperative morbidity in the main group decreased by 61.7% (χ2=3.897, p<0.05). Better tissue healing in the area of intestinal anastomosis and laparotomy under Remaxol therapy was demonstrated. CONCLUSION: Inclusion of Remaxol in complex therapy of acute intestinal obstruction complicated by peritonitis can significantly improve treatment outcomes, reduce the number of complications and increase reparative potential of tissues. Positive effect of this drug is based on less oxidative stress, phospholipase activity and hypoxia.