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№3' 2017
SURGERYInternational Medical Journal, Vol. 23., Iss. 3, 2017, P. 35−38.
ANALYSIS OF THE RESULTS OF ESOPHAGEAL ANASTOMOSIS SUTURE FAILURE TREATMENT
V. T. Zaytsev Institute of General and Emergency Surgery (NAMS of Ukraine)
Kharkiv National Medical University, Ukraine
Digestive tract anastomosis suture failure is one of the most critical postoperative complications in thoracoabdominal surgery. Until now the researchers have searched for the ways of optimizing treatment of patients with this complication. The desire to find cheap and safe, but at the same time effective methods of treatment of this category of patients led to development and deployment in clinical practice of methods of endoprosthesis replacement. According to the literature, this complication is observed in 3.3ЃE.9 % of cases with a mortality of 78.6ЃE0.0 %. The main tasks of the treatment for suture failure are elimination of the connection between the hollow organ and adjacent tissues, adequate sanation of the area around the failure, general antibacterial therapy, correction of homeostasis disorders. The clinical section of a research is based on the analysis of the results of treatment of 68 patients treated at V. T. Zaytsev Institute of General and Emergency Surgery in 2006ЃE016. Anastomosis failure in all patients occurred in the early postoperative period. The main method for diagnosing of anastomosis suture failure was radiological. The main method of treatment in one group of patients was transplantation of a transnasal probe, in the other group surgical tactics were used for early diagnosis of failure and treatment using mini−invasive technologies, primarily stenting of the failure area. After successful implementation of the stent the clinical effect was reached in 66.3 % of patients. Stenting of the esophagus with self−straightening devices with coating and antireflux valves is a method of choice in treatment of patients with esophageal anastomosis failure. It allows to avoid traumatic operations, especially in weakened patients and to save the life of the patients with these critical complications.
Key words: esophagus, endoscopic stenting, anastomosis failure.