RU1830249C - Method for intraoperational diagnosis of sealing of intestinal anastomosis - Google Patents

Abstract

The invention relates to medicine, in particular to surgery and proctology, and relates to monitoring the tightness of a large intestine anastomosis. The purpose of the invention is to reduce the morbidity and increase the accuracy of diagnosis. The goal is achieved by rectally administering to the colonic anastomotic region a contrast preparation in the form of a foam under pressure from an aerosol can. An antiseptic containing iodine, potassium and polyvinyl pyrrolidone is used as a contrast medium. The method allows to reduce, avoid infection of the abdominal cavity.

Description

The invention relates to medicine, in particular to surgery and proctology, and relates to intraoperative diagnostics of anastomosis tightness.

The purpose of the invention is to reduce the travmosticity and increase the accuracy of diagnostics of the integrity of intestinal anastomosis.

The goal is achieved by injecting a colored solution in the form of an aerosol foam under pressure into the intestinal lumen.

The method is carried out as follows.

After closing the anastomosis across the colon, a soft grip proximal to the suture line. The colon through the nozzle or through the worn catheter is rectally filled with foam from an aerosol can stained with an antiseptic (iodopyron, iodovidone or povidone iodine). Then, for 2-3 minutes, the presence of leakage of the colored foam through the anastomosis is observed,

Example 1. Patient I was operated on for rectal adecocarcinoma at 16 cm. Ta x -Mo performed a low anterior resection of the rectum, end to end anastomosis AKA-2. The tightness of the anastomosis was verified by transanal administration of foam with povidone-iodine on the operating table. No foam seeping; the anastomosis is sealed. The postoperative course is smooth.

Example 2. Patient A. was operated on for an incomplete lip-shaped fistula of the sigmoid colon, anastomosis of 3/4 according to Melnikov was performed by separate nodular nylon sutures in two rows. The tightness of the anastomosis was verified by transanal injection of foam with iodovidone. Penetration of colored foam was noted at the joint of the joints in a 1 mm area. Two seams are laid. When re-checking the anastomosis is tight. The postoperative course is smooth.

The claimed diagnostic method is simple to implement, quickly feasible, allowing

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without any difficulties and promptly perform early diagnosis of intestinal anastomoses, which provides objectivity in 100% of cases. Using this method allows you to reduce or completely eliminate the complications after operations on the colon, associated with leakage of sutures. The use of antiseptics as a contrast medium (iodopyron, iodovidone or povidone iodine) enhances the positive effect due to their antimicrobial effect, which reduces purulent complications due to other reasons: significant colon microbial contamination, lowered immunity of patients, etc.

Claims (2)

1. A method of intraoperative diagnostics of the tightness of the intestinal anastomosis, including the introduction of a colored solution under pressure into the intestinal lumen, with the exception of the fact that, in order to reduce the morbidity and increase the diagnostic accuracy, the colored solution is administered as aerosol foam. 2. The method according to claim 1, with the fact that, in order to prevent infection of the abdominal cavity, antiseptics are used as a contrast preparation, which are a complex of iodine, potassium and polyvinylpyrrolidone.