Novosti
Khirurgii

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Year 2015 Vol. 23 No 6

GENERAL & SPECIAL SURGERY

A.V. STAKANOV 1, À.Å. MURONOV 1, S.Y. EFANOV 2

HYPERBARIC OXYGEN THERAPY OF ACUTE COLONIC OBSTRUCTION

SBEE HPE "Kuban State Medical University" 1
SBEE HPE "Rostov State Medical University"2,
The Russian Federation

Objectives. To evaluate the effectiveness of hyperbaric oxygen therapy in patients after elimination of acute colonic obstruction.
Methods. The study enrolled 263 patients with acute colonic obstruction (ACO). All patients were divided into two groups: I – comparison group with basic therapy (n=118) and II – main group (n = 145), where in the postoperative period starting from the 2nd-3rd days hyperbaric oxygen therapy (HBO) was applied together with a standard therapy. The primary surgeries were: a bowel resection, laparotomy, applying of colo- (ceco-, transverso-, sigmo-) stomy, nasointestinal intubation of the small intestine and stomach. Patient’ gender and age characteristics as well as the severity of the early perioperative period estimated according to the dynamic APACHE III scale had no differences. The duration of operations, anesthetic treatment and stay in the intensive care unit are comparable. The presence of comorbidities in patients of both groups is without any significant differences.
Results. In the postoperative period the use of HBO reduces the incidence of postoperative complications, significantly reducing the pneumonia percentage by 9,7%, acute respiratory distress syndrome (ARDS), delirium – by 7,5%, paresis of the gastrointestinal tract for more than 3 days by 5,8%, septic complications by 3,5%. The development of acute kidney injury, left ventricular failure, postoperative myocardial infarction, as well as hypotension requiring vasoactive support, occurred in a comparable number of observations. Complications associated with pulmonary embolism, brain ischemia, acute gastrointestinal bleeding were considered to be similar in both groups. Medical and economic feasibility of HBO application in complex therapy in case of acute colonic obstruction (ACO) is based on statistical trends reducing the length of hospital stay by two days, the need for reoperation – by 3,5%, in-hospital mortality rate – by 3,1%.
Conclusion. The performed study gives the opportunity to recommend the use of hyperbaric oxygen therapy after elimination of acute colonic obstruction.

Keywords: hyperbaric oxygen therapy, abdominal surgery, acute colonic obstruction, hospitalization, complications, postoperative period, mortality rate
p. 624-630 of the original issue
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Address for correspondence:
344010, Russian Federation,
Rostov-na-Donu, pr. Voroshilovskiy, d. 105,
GBOU VPO "Rostovskiy gosudarstvennyiy meditsinskiy universitet"
kafedra obschey khirurgii,
tel. mob. 7 903 406-00-97, e-mail: efanov_su@mail.ru,
Efanov Sergey Yurevich
Information about the authors:
Stakanov A.V. PhD, an applicant for Doctor’s degree of anesthesiology, reanimatology and transfusion chair of the advanced training faculty and retraining of specialists of SBEE HPE "Kuban State Medical University" of the Ministry of Health of Russia.
Muronov A.E. PhD, an associate professor of anesthesiology, reanimatology and transfusion chair of the advanced training faculty and retraining of specialists of SBEE HPE "Kuban State Medical University" of the Ministry of Health of Russia.
Efanov S.Y. PhD, an assistant of the general surgery chair of SBEE HPE "Rostov State Medical University".
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