EARLY AND LONG-TERM RESULTS OF SURGICAL TREATMENT OF PERITONEAL ADHESIONS. RETROSPECTIVE ANALYSIS

 Introduction. Due to the growth in the number and volume of surgical interventions on abdominal organs, as well as associated pathology, resulting in frequent postoperative complications, there has been an increase in the frequency and severity of the current adhesive disease of peritoneum. The main purpose of the project is to analyze early and delayed results in surgical treatment of peritoneal adhesions. Materials and methods. The work includes a retrospective analysis of data with emergency surgical pathology in the period 1997-2008 of 638 patients, that have undergone medical care regarding peritoneal adhesions at the clinic as a part of BSMU (city of UFA). In the total structure of patients the prevailing group was the one with acute ileus (52%), requiring emergency surgery. Depending on the type of surgery the operated patients were divided into two groups: an adheolysis group of 302 patients (91%); and a group of adhesiolysis + bowel resection with anastomosis of 30 patients (9%). Results. The findings showed that the early postoperative complications manifested in the form of early adhesive intestinal obstruction and anastomotic dehiscence, requiring repeated surgeries. In the group with the adhesiolysis, such interference was carried out for 42 patients (14%). Anastomosis group has undergone complications in 8 patients (27%): the subgroup of double layer anastomosis - in 6 patients (29%), subgroup of single layer anastomoses - 2 patients (22%). Conclusion. It has been noted that the frequency of early complications after anastomoses remains high (27%), and reliably is not different, as with the use of the double layer (29%), and with the use of single-layer intestinal stitch (22%). Deferred results demonstrate the return of symptoms during the first year in 217 patients (47%). And the high frequency to form clinical signs of peritoneal adhesions in 68% of patients still remains within two years after surgery.

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