The article studies the influence of proximal colostomy formed through minimal access for microbial contamination of the abdominal cavity during the radical phase of treatment and the dynamics of the inflammatory changes and intoxication syndrome in patients with rectal cancer complicated by acute obstruction. The research on microbial contamination of the abdominal cavity was made in 32 patients, including 15 patients in whom obstruction was resolved conservatively and 17 patients in whom was made a proximal colostomy through mini-invasive access to eliminate acute obstruction. In 30 patients were investigated acute phase proteins and determined the level of toxemia available by calculation leukocyte index of intoxication. Blood sampling was carried out in patients with acute intestinal obstruction directly before applying the proximal colostomy, and before the second - a radical step treatment in 7-10 days. Found that the imposition of the proximal colostomy through minimal access does not lead to an increase in microbial contamination of the abdomen; helps reduce the level of acute phase proteins, the level of general toxemia and reduces the risk of postoperative inflammatory complications before performing radical phase of treatment.
colostomy, mini-invasive access, ileus, microbial contamination, intoxication syndrome.
1. Azhavi A.M., Slesarenko S.S. Assistirovannye vmeshatel´stva v lechenii bol´nykh s ostroy obturatsionnoy tolstokishechnoy neprokhodimost´yu opukholevogo geneza. Mezhdunarodnyy khirurgicheskiy kongress ”Novye tekhnologii v khirurgii”. Mater. Kongressa. Rostov-na-Donu, 2005. S. 339.
2. Vorob´ev G.I., Shelygin Yu.A., Frolov S.A., Sorokin V.V. Vybor metoda khirurgicheskogo lecheniya oslozhnennykh i rasprostranennykh form kolorektal´nogo raka. IX Vseros. s´´ezd khirurgov. Mater. S´´ezda. Volgograd, 2000. S. 154.
3. Gadzhiev M.S. Endovideokhirurgicheskie tekhnologii v lechenii obturatsionnoy tolstokishechnoy neprokhodimosti. XI s´´ezd khirurgov Rossiyskoy Federatsii: Tez. dokl. Volgograd, 2011. S. 81-82.
4. Pugaev A.V., Achkasov E.E. Obturatsionnaya opukholevaya tolstokishechnaya neprokhodimost´. Moskva, 2005. 223 s.
5. Timerbulatov V.M., Fayazov R.R., Mekhdiev D.I., Gareev R.N., Timerbulatov Sh.V., Akhmerov R.R., Sul-tanbaev A.U. Sovremennyy podkhody v khirurgicheskoy taktike pri oslozhnennom rake tolstoy kishki. Koloproktologiya. 2011. №3 (37). Prilozhenie. S. 89.
6. Totikov V.Z., Zuraev K.E., Totikov Z.V., Kachma-zov A.K., Dzhioev S.A. Khirurgicheskaya taktika pri rake pryamoy kishki, oslozhnennom neprokhodimost´yu. Koloproktologiya. 2005. №2(12). S. 36-39.
7. Totikov V.Z., Totikov Z.V. Rak pryamoy kishki, oslozhnennyy ostroy obturatsionnoy tolstokishech-noy neprokhodimost´yu. Vladikavkaz, 2011. 150 s.
8. Totikov Z.V. , Totikov V.Z., Talapova I.M., To-tikov M.Z., Aslanov A.D. Sposob formirovaniya dvu-stvol´noy petlevoy kolostomy pri tolsto-kishechnoy neprokhodimosti opukholevogo geneza. Koloproktologiya. 2013. №1(43). S.39-43.