Leakage prevention of entero-colonic anastomoses in emergency surgery
Yu. S. Vajner,
A. E. Babyuk,
P. I. Averkin,
E. R. Atamanova,
M. V. Beznosikova,
E. G. Sal’nikova,
Yu. V. Ivanova,
O. A. Chulikova,
K. V. Atamanov https://doi.org/10.31146/1682-8658-ecg-182-10-123-128
Abstract
The problem of entero-colonic anastomosis leakage in emergency surgery has always been under close medical community attention. The more proximal intestinal sutures are located, the more severe the consequences are. In case of a left half of the colon the solution of the problem is relatively safe colostomy. Treating a patient with entero-colonic anastomosis leakage, the question arises about the ileostomy, which leads to more serious consequences (water-electrolyte disbalance). Most of these patients get treatment for complicated colon cancer, which worsens the prognosis. In general, the risk of entero-colonic anastomosis leakage in emergency surgery reaches 12.7%. The risks are: inadequate assessment of blood fl ow in the suture line, peritonitis, diabetes, smoking, severe ileus, intraoperative blood transfusion, a small experience of a surgeon in performing these operations.
Nowadays there are many ways to prevent anastomosis leakage. They are: application of compression devices of Ni-Ti with simultaneous U-shaped ileostomy, biodegradable rings, consolidation of intestinal sutures with «TachoComb» biopolymer substance application, various adhesive compositions, gland. Oblique intersection of the intestinal wall also uses to increase blood fl ow on the suture line, correction of infusion therapy is discussed with inclusion of hydroxyethyl starch. However, the zero frequency of the leakage in the clinic still cannot be achieved.
Accordingly, nowadays, the problem of optimal entero-colonic anastomosis technique remains open. It should meet the following requirements: ideally, a zero frequency of leakage; a technical simplicity of the operation; preferably, without using expensive materials; as far as possible — a valve to prevent refl ux ileitis.
Nowadays there are many ways to prevent anastomosis leakage. They are: application of compression devices of Ni-Ti with simultaneous U-shaped ileostomy, biodegradable rings, consolidation of intestinal sutures with «TachoComb» biopolymer substance application, various adhesive compositions, gland. Oblique intersection of the intestinal wall also uses to increase blood fl ow on the suture line, correction of infusion therapy is discussed with inclusion of hydroxyethyl starch. However, the zero frequency of the leakage in the clinic still cannot be achieved.
Accordingly, nowadays, the problem of optimal entero-colonic anastomosis technique remains open. It should meet the following requirements: ideally, a zero frequency of leakage; a technical simplicity of the operation; preferably, without using expensive materials; as far as possible — a valve to prevent refl ux ileitis.
About the Authors
Yu. S. Vajner
Federal state budgetary educational institution of higher education Novosibirsk state medical University of the Ministry of health of Russia
Russian Federation
Russian Federation
candidate of medical Sciences, docent of the Department of faculty surgery
Russia, 630091, Siberian Federal district, Novosibirsk region, Novosibirsk, Krasny prospect, 52
A. E. Babyuk
Federal state budgetary educational institution of higher education Novosibirsk state medical University of the Ministry of health of Russia
Russian Federation
Russian Federation
4th year student of the medical faculty
Russia, 630091, Siberian Federal district, Novosibirsk region, Novosibirsk, Krasny prospect, 52
P. I. Averkin
Federal state budgetary educational institution of higher education Novosibirsk state medical University of the Ministry of health of Russia
Russian Federation
Russian Federation
5th year student of the medical faculty
Russia, 630091, Siberian Federal district, Novosibirsk region, Novosibirsk, Krasny prospect, 52
E. R. Atamanova
Federal state budgetary educational institution of higher education Novosibirsk state medical University of the Ministry of health of Russia
Russian Federation
Russian Federation
5th year student of the medical faculty
Russia, 630091, Siberian Federal district, Novosibirsk region, Novosibirsk, Krasny prospect, 52
M. V. Beznosikova
Federal state budgetary educational institution of higher education Novosibirsk state medical University of the Ministry of health of Russia
Russian Federation
Russian Federation
4th year student of the medical faculty
Russia, 630091, Siberian Federal district, Novosibirsk region, Novosibirsk, Krasny prospect, 52
E. G. Sal’nikova
Federal state budgetary educational institution of higher education Novosibirsk state medical University of the Ministry of health of Russia
Russian Federation
Russian Federation
4th year student of the medical faculty
Russia, 630091, Siberian Federal district, Novosibirsk region, Novosibirsk, Krasny prospect, 52
Yu. V. Ivanova
Federal state budgetary educational institution of higher education Novosibirsk state medical University of the Ministry of health of Russia
Russian Federation
Russian Federation
4th year student of the medical faculty
Russia, 630091, Siberian Federal district, Novosibirsk region, Novosibirsk, Krasny prospect, 52
O. A. Chulikova
Federal state budgetary educational institution of higher education Novosibirsk state medical University of the Ministry of health of Russia
Russian Federation
Russian Federation
4th year student of the medical faculty
Russia, 630091, Siberian Federal district, Novosibirsk region, Novosibirsk, Krasny prospect, 52
K. V. Atamanov
Federal state budgetary educational institution of higher education Novosibirsk state medical University of the Ministry of health of Russia
Russian Federation
Russian Federation
doctor of medical Sciences, associate Professor, head of the Department of faculty surgery
Russia, 630091, Siberian Federal district, Novosibirsk region, Novosibirsk, Krasny prospect, 52
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For citations:
Vajner Yu.S., Babyuk A.E., Averkin P.I., Atamanova E.R., Beznosikova M.V., Sal’nikova E.G., Ivanova Yu.V., Chulikova O.A., Atamanov K.V. Leakage prevention of entero-colonic anastomoses in emergency surgery. Experimental and Clinical Gastroenterology. 2020;(10):123-128. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-182-10-123-128
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