The possibilities of early diagnosis of tumorous lesions of colon patency and their preoperative correction

2005 
: Experiments in white rats were used in order 1) to create a model of obturative colon obstruction (OCO) and to prove a staged character of its development depending on the tone of the Bauhin's valve (the normotonic phase, spasm of the Bauhin's valve, dilatation of the Bauhin's valve) and 2) to study specific features of healing primary anastomoses after emergency resections of the colon. An analysis of clinical and rentgenological findings has confirmed the staged character of tumor lesions of the colon patency (TLCP). A working classification of them is proposed: stages of compensation (conventionally chronic); subcompensation (subacute) with three degrees of stages according to the experimental scheme of pathogenesis; decompensated (acute obturative colon obstruction). Typical rentgenological symptoms are first described and systematized for the stages of sub- and decompensation. In combination with the classification they make the basis for early diagnosis of TLCP, establishment of absolute indications for urgent operations and decision for the early intraoperative strategy. An original three-lumen probe for preoperative decompression and monitory purgation of the intestine, the method of intra- and postoperative decompression, correction of the intraintestinal status allowed to form primary anastomoses after urgent resections of the colon in 170 (63.7%) out of 317 patients with OCO. A scheme of control with the help of thermo-transducer is proposed for prognosis of a possible failure of the anastomosis.
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