Abstract:
It is known that reperfusion of the bowel after its preliminary obstruction at first does not result in restoring the structure of the tissues, but vice
versa – in deepening the necrobiotic and necrotic processes with the formation of acute erosions in the mucosa due to the vascular plegic disorders of
haemomicrocirculatory bloodstream. In the experiment on rats a new method for preventing the reperfusion syndrome has been developed, and its
morphological and morphometric rationale has been given. The method consists in the fact that, before removing the cause of obstruction, we have
superimposed on the intestine above its narrowing two catgut ligatures of different thickness at the interval of 1 cm between them. The first gut ligature
has narrowed the intestine diameter to the size of its diameter below the obturation, and the second one – to the size of the normal diameter. The
application of this method allows to significantly reduce the likelihood of the phenomenon of «no-reflow», meaning the non-resumption of blood flow
in the vessels of the organ after the surgical elimination of an acute vascular occlusion and, thus, to prevent the rapid development of the reperfusion
syndrome and multiple organ failure. The above becomes possible thanks to the gradual restoration of the patency of the small intestine and smooth
reduction of internal and external pressure on its wall above the obstruction site during the swelling and stretching of catgut ligatures with their subsequent
fragmentation and dispersal. Besides, the gradual filling of the intestinal lumen with the intestinal content below the obturation site allows reducing
the intraluminal pressure in the anastomosis zone (if the surgery comprises the step of the bowel resection) and, thereby, to prevent the intestinal seam
failure. The morphometric confirmation of the effectiveness of the method has been Vogenvort’s index dynamics in the arteries of the small intestine.
