METHOD FOR SURGICAL MANAGEMENT OF PERFORATED TUBERCULOSIS ULCERS OF THE SMALL INTESTINE COMPLICATED BY PERITONITIS Russian patent published in 2020 - IPC A61B17/00 A61B17/115 A61M25/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to abdominal surgery. Small intestine segment is resected with perforated tuberculosis ulcers within the limits of healthy tissues at distance of 10 cm in the proximal and distal direction or a right-sided hemicolectomy is performed. Stump of the small intestine is closed with the help of linear stapling apparatuses by two rows of fastening sutures with a height of staples of 3.8 mm and the mesentery is treated with staplers with the staple height of 2.5 mm. Small intestine is intubated to its proximal stump by a naso-intestinal Miller-Abbot probe with active aspiration. Abdominal sanation is performed, 2-4 program sanation relaparotomy is carried out until relief of peritonitis. During program re-laparotomy in the absence of peritonitis phenomena, antiperistaltic delayed intestinal anastomosis is applied "side-to-side" by means of stapling apparatuses, by means of coagulation of a hole in the intestine, below 8 mm-sized staples, the intestines are aligned by the anti-mesenteric edge and the sutures are brought into the aperture. Stapling-cutting apparatus is sutured with intestinal walls. On the formed single stump 5 strands of holders are applied, grasping orifices of an intestine, through which branches are introduced, and a single stump is stitched with a sewing-cutting apparatus, without additional reinforcement by sutures of the anastomosis. Naso-intrinsic probe is inserted behind anastomosis by 20 cm, the abdominal cavity is closed tightly, and after 48-72 hours the probe is removed.

EFFECT: method allows arresting and preventing the development of pyoinflammatory complications, to reduce the length of stay of the patients in the clinic, improving the results of treatment in the early postoperative period, reducing lethality.

1 cl, 3 ex