PREDICTION OF THE PERITONEAL ADHESION DISEASE AFTER SURGICAL INTERVENTIONS ON THE ORGANS OF THE PERITONEAL CAVITY

Abstract

Adhesion disease (AD) is a serious disease that occurs as a result of various pathological processes, mainly of an infl ammatory nature and is characterized by an unpredictable course, disability, and a wide range of complications. At the current stage, there is no reliable system for predicting adhesion formation and the development of AD, which confi rms the relevance of this direction of research.The aim of the study. To evaluate the prognostic value of various factors of the occurrence of adhesions in order to use them in the system of forecasting the development of adhesion disease.Material and methods. The study is based on the analysis of clinical data of 102 patients with AD. Patient management, diagnosis and treatment of complications were carried out in accordance with the recommendations of the Bologna guidelines for diagnosis and management of adhesive small bowel obstruction… (2018). Statistical analysis was carried out using the Clinical Calculator 1 computer program. In order to assess the prognostic value of various parameters, the prevalence, sensitivity and specifi city of the symptom, the ratio of the chances of the occurrence of the disease associated with the symptom were calculated.Results of the study. It has been shown that the presence of peritoneal infl ammation in the anamnesis signifi cantly increases the risk of adhesion formation. Transferred peritonitis is an important prognostic marker of the occurrence of AD, however, the low sensitivity of this parameter emphasizes the impossibility of its isolated use for prognostic purposes. The risk of adhesion formation due to peritonitis increases 4.8 (0.7-32.18) times. A slightly higher risk of adhesion formation was determined during colorectal operations, however, this dependence was unlikely. The risk of developing AD as a result of open operations is 1.77 (0.92-3.41), the presence of intestinal obstruction in the anamnesis increases the risk of AD developing by 1.86 (0.96-3.62) times.Conclusions. No statistically signifi cant relationship between the occurrence of adhesions of the peritoneal cavity and the gender distribution, term and type of surgical interventions was established. Open access, history of obstruction, and peritonitis are the most important factors that create the highest risk for adhesions.