Морфометрическая характеристика артерий тонкой кишки при моделировании её непроходимости

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.