Possibilities of Endoportal Infusion Therapy for Intra-Abdominal Surgical Infections Complicated by Acute Intestinal Failure

Abstract

The purpose of this study was to evaluate the effectiveness of EIT for intra-abdominal infections complicated by acute intestinal failure. Materials and Methods: The authors modified the technique of catheterization of the right gastroepiploic vein to conduct prolonged endoportal infusion therapy. The modification allows for easy surgery and successful removal of the catheter upon completion of endoportal infusion therapy. This operation is possible using video laparoscopic access. An antihypoxic agent, an antibiotic, and a hepatoprotector were given as an endoportal bolus. The technique was carried out on 24 patients with various purulent-inflammatory diseases of the abdominal organs complicated by acute intestinal failure. The results were compared with a group of 24 patients treated with traditional methods. Research Results: As a result of the study, it turned out that in the main group, indicators returned to normal according to the systems for assessing the severity of the condition (APACHE II and abdominal index) and signs of intestinal failure (EMFC) on the day 5 of treatment. At the same time, in the comparison group, these changes occurred only on the day 7 of treatment (p≤0.05). The values of enzymes reflecting the state of the intestinal wall, as well as indicators of cellular immunity were normalized by day 3 in the main group, and by day 7 in the comparison group (p≤0.05). Conclusion: The proposed EIT technology can serve as a good supplement to the treatment of patients with intra-abdominal purulent-inflammatory diseases complicated by acute intestinal failure. It prevents bacterial translocation into the portal system and thus reduces the risk of generalized infection and multiple organ failure.