Our experience of phototherapy application for the prevention of the inconsistency of seams of intestinal anastomoses
Abstract
Introduction. The problem of destructive complications from the side of the intestinal wall with a violation
of its integrity is still far from being resolved. With the destruction of the intestine, complicated by peritonitis,
the possibility of simultaneous restoration of the continuity of the intestinal tube is questioned due to the threat
of the development of failure of the sutures. Suture failure is caused by a purulent-inflammatory process and the
disturbances of intramural blood flow and microcirculation that accompany it or precede it (with strangulation).
The aim of the work is to develop methods for preventing the development of insolvency of sutures of the
intestinal anastomoses.
Materials and methods. The paper presents a methodology developed by the authors for treating
patients who underwent resection of segments of the small intestine using local phototherapy. The study is
based on comparing the treatment results of 15 patients, of which 8 made up the comparison group (group 1)
and 7 patients (group 2) of the main group. Phototherapy was carried out through an additionally installed
drainage with a quartz-polymer light guide with a diameter of 400 μm, with a radiation wavelength of 660 nm,
and a radiation power of 50 mW. Clinical, laboratory and instrumental indicators (electrogastroenterography),
as well as the number of postoperative complications, were evaluated.
Results. In patients of group 2, at an earlier date, the general condition and clinical and biochemical
parameters returned to normal; on the 2nd–3rd day of the postoperative period, restoration of peristalsis was
noted, on the 4th–5th day, the passage along the gastrointestinal tract was restored. In one group, in one observation, an intestinal anastomosis was insolvent, which required relaparotomy, in two cases the postoperative period was complicated by the development of suppuration of postoperative wounds, and in group 2 there were no purulent-inflammatory complications.
Findings. The use of phototherapy of intestinal anastomoses indicates its effectiveness, which, in our
opinion, can be explained by such effects of light exposure as bacteriostatic, immunomodulating, as well as
improved microcirculation. This technique is simple, minimally invasive and has a significant economic effect.
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References
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