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Eksperimental'naia i klinicheskaia gastroenterologiia = Experimental & clinical gastroenterology 2015

[THE CLINICAL COURSE OF THE ISOLATED EFFECTS OF EXTENSIVE SMALL INTESTINE RESECTION IN THE LATE POSTOPERATIVE PERIOD].

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T N Kuzmina
A V Petrakov
C Yu Silvestrova

Ключевые слова

абстрактный

The purpose is the postoperative period study of clinical and functional status of patients after small intestine resection, which was performed in different volume

METHODS

91 patients with sequelae of small intestine resection in different terms after the operation were surveyed. Patients were assessed for clinical symptoms on a scale "Method of evaluating intestinal failure after gastric resection", in our own modifications, clinical-laboratory and biochemical blood examination, ultrasound examination of abdominal cavity and kidneys, x-ray examination of the gastrointestinal tract, esophagogastroduodenoscopy with histological examination of the mucosa. We determined the scatology, the consistency of the feces on the Bristol scale, concentration and profile of short chain fatty acids in coprofiltrates. Blood serum Citrulline was determined using high performance liquid chromatography on the chromatograph "Stayer". The degree of nutritional risk was assessed using screen questionnaire NRS-2002 RESULTS: Analysis of clinical, anthropometric and laboratory data showed that patients with residual stumps of the small intestine more than 2 meters have a distinct tendency to stabilize their condition, confirmed by the level of citrulline in the serum. At the same time complete adaptation does not occur, because the main reason of the operation is adhesive intestinal obstruction with chronic relapsing course. Patients with stumps of the small intestine less than 2 m have highly individual adaptation, which may be due to a small sample of patients in this group. The detected changes in the concentration and profile of coprofiltrat short-chain fatty acids allow differentiated approach to therapy of diarrhea syndrome as the main clinical manifestations of the effects of isolated small intestine resection.

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