PREVENTION OF COLONIC ANASTOMOSIS FAILURES

Aim. Improving treatment outcomes for patients undergoing resection and reconstructive interventions on the colon by improving methods for preventing colonic anastomosis failure.
Materials and methods. The study included 96 patients undergoing treatment for colon diseases. Seventy-seven patients underwent resection with primary interintestinal anastomosis, while 19 patients underwent closure of previously established stomas, which is considered reconstructive surgery. To analyze the frequency of early postoperative complications, all patients were divided into two groups: main and control. In the main group, consisting of 47 patients, specially developed preventive and therapeutic measures were used in the postoperative period to reduce the risk of colonic anastomotic leakage (CAL). The control group included 49 patients who, after resection and reconstructive operations on the colon, received standard medical care based on generally accepted principles for managing such patients.
Results. In patients of the main group (n = 47), in the early postoperative period, the developed methods for the prevention of CAL were used: transcolonal local laser stimulation, transcolonal local administration of the antiseptic decasan, dynaton and mexidol, as well as NO-containing drugs in the area of the formed colonic anastomosis. Patients in the control group (n = 49) received standard, generally accepted treatment in the early postoperative period without the use of developed methods for preventing CAL. No cases of CAL were observed in the study group in the early postoperative period, whereas CAL developed in 4 patients (8.1%) in the control group.
Conclusion. Thus, the proposed methods for preventing colonic anastomotic failure contribute to improving the results of resection and reconstructive interventions on the colon due to timely healing of the anastomotic line and a reduction in the incidence of infectious and inflammatory postoperative complications, including cases of anastomotic failure.

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