Method of evaluation of viability of the bowel wall

Abstract

Introduction: Evaluation of bowel wall viability (BWV) - is one of the unsolved problems of abdominal surgery. Determination of circulatory disorders of intestine, identifying areas of necrosis determines to choose the amount of resection, the suture place and their capacity. When using the methods based on visual inspection, the probability of the results to a large extent determines the factors that influence the degree of which it is impossible to assess and make appropriate adjustments. This makes the actual search for new methods that allow to adequately and quickly asses the viability and depth of morpho-functional changes in the intestinal wall. The purpose of the experiment was to investigate the changes in spectral and photoplethysmography information in the development of bowel necrosis, to develop new methods of determining BWV intestinal wall. Materials and Methods 12 rabbits of both sexes, with no obvious signs of disease and with normal values of laboratory tests were included in experiment. Modeling ischemia of the small intestine was carried out by the original method (certificate of innovative proposal № 69/05), which enables to simulate the projected degree of ischemia. The degree of ischemia measured by the original technique (patent of Ukraine for utility model №25701), which allows the non-invasive determination of hemoglobin oxygenation of arterial blood. Results: Evaluation of the morphological changes of the bowel wall were carried out by histochemical (Schiff reaction, alkaline phosphatase and nonspecific esterase mucosa of the small intestine) and histological (hematoxylin-eosin staining) study. Conclusion: Informative study of the proposed method showed that the proposed original method of assessment of bowel viability provides rapid quantitative assessment of the degree of oxygenation of the intestinal wall, which is closely correlated with its viability. The method is convenient and easy to use, enabling its wide application in practical surgery. The proposed method of bowel viability involves highly probable, noninvasive assessment of the degree of oxygenation of the intestinal wall, which allows preventing of life-threatening complications in surgical interventions on digestive tract.