ISIT POSSIBLETO PREDICT POSTOPERATIVE ABDOMINAL COMPLICATIONS BYLASER DOPPLER FLOWMETRY?

Abstract

In this study, the authors chose to assess the prognostic capabilities of the laser Doppler flowmetry method for postoperative complications in patients with advanced peritonitis. A retrospective randomized controlled trial (evidence level IIB) was performed. The study involved 54 patients who were operated on for secondary widespread fibrinous-purulent peritonitis. The patients were divided into two groups with 27 patients in each: the main group — with developed postoperative complications and a comparison group — without complications. The research was carried out by the analyzer "Lazma MC-1" (Russia). Scanning of the parietal and visceral peritoneum, small and large intestines, as well as the edges of the laparotomic wound was performed. A total of 504 scans were performed. The relationship of indicators was determined using the Spearman's rank correlation coefficient. Microcirculation indices in both groups were characterized by pronounced disorders of pre- and postcapillary resistance and disorders of tissue perfusion. The following indicators turned out to be statistically significant: percentage of microcirculation (r= 0.77 at p≤0.05), standard deviation (r = 0.67 at p≤0.05), coefficient of variation (r = 0.59 at p≤0, 05) and shunting percentage. In patients of the main group, the changes were expressed in an increase in pre- and postcapillary resistance, progressive arterio-venular shunting. All this ultimately led to disturbances in the perfusion of the intestinal wall, peritoneum and laparotomic wound, which led to postoperative complications. The technique of abdominal laser Doppler flowmetry can be a prognostic method that allows predicting the development of early postoperative complications after primary surgery and making appropriate adjustments to the treatment.