ADHESIVE OBSTRUCTION OF THE SMALL INTESTINE: FEATURES OF DIAGNOSIS AND TREATMENT IN THE CONTEXT OF MINIMALLY INVASIVE TECHNOLOGIES: review

The review presents a modern view on the features of the course and treatment of adhesions of the small intestine, based on modern epidemiological data, accepted guidelines for the diagnosis and nature of the treatment of different categories of patients. It is noted that adhesive intestinal obstruction is a symptom complex due to violation of the movement of contents through the intestines due to the presence of adhesions in the abdominal cavity after operations and injuries. Attention is drawn to the peculiarities of diagnostics of various forms of the disease, which include the leading clinical symptoms, data of X-ray methods (X-ray and CT of the abdominal cavity), MRI, assessment of various biomarkers, indicators of the severity of the patient's condition. It is noted that at present the primary task in solving this problem is to study several controversial issues in this area. The main provisions of measures for the treatment of adhesive obstruction of the small intestine, based on the principles of non-surgical treatment in a certain category of patients, the use of surgical interventions strictly according to indications, especially in patients who need to perform repeated operations, were highlighted. Among them, special attention is paid to the features of open and minimally invasive surgical interventions. It is emphasized that at present, minimally invasive surgical interventions perform the main tasks of surgical treatment for adhesive ileus of the small intestine and significantly reduce surgical trauma in comparison with "open" methods of treatment, but these interventions have not widespread in the world yet.