Features of Choice of Operative Tactics for Acute I Ntestinal Obstruction and Diffused Peritonitis

Abstract

Summary. The aim of the study was to evaluate and compare the early postoperative outcomes of patients with GKN who received either primary anastomosis or only stoma formation after bowel resection with the identification of factors associated with postoperative complications and mortality in both groups of patients.
 Materials and methods. The study included 63 patients with acute intestinal obstruction and peritonitis who underwent resection of the small intestine followed by the formation of a jejunostomy. The factors affecting the choice of the option of completing the surgical intervention were studied.
 Research results. Under relatively equal conditions, after resection of the small intestine in patients with acute intestinal obstruction and peritonitis other than vascular etiology, preference should be given to interintestinal anastomoses with a Meidl jejunostomy for the purpose of «unloading», when obstruction caused by vascular pathology is detected — the preference is on the side temporary terminal uenostomy with staged interventions according to indications.
 Conclusions. After resection of the small intestine in case of non-vascular etiology, preference should be given to interintestinal anastomosis or Y-shaped anastomosis according to Meidl. The only risk factor for mortality is postoperative multiple organ failure.