METHOD FOR ELIMINATING OESOPHAGEAL WALL LESIONS AND DIGESTIVE TUBE PROXIMAL ANASTOMOSIS INCONSISTENCY

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to abdominal and thoracic surgery. If observing the oesophageal wall lesions and inconsistent sutures of the anastomoses of the proximal digestive tubes, a porous bioinert sponge with pore size of 400–600 mcm is used for aspiration of the pathologically separated body cavity. That is ensured by endoscopic determination of the size of the defect and formation of a sponge sized to match the size and shape of the defect, plus 3 cm extending beyond its edge. A drain tube is inserted into the sponge and fixed by means of surgical units on the proximal and distal ends of the sponge. Then the sponge is soaked with physiologic saline and placed in a soft sealed silicone cover. Its open end is tightened tightly with a suture. Drainage is connected to vacuum pump with negative pressure minus 200 mm Hg, air is removed and freezing sponge soaked with physiologic solution in tight silicone jacket at minus 18 °C for 25 minutes, after which the cover is removed and immediately afterwards the sponge is orally introduced into the digestive tube under endoscopic control, laid on the defect and connected to a pressure of minus 125 mm Hg, wherein every 3 days, only 4–9 times, the sponge is replaced by the similar one.;EFFECT: method considerably reduces the time of manipulation, reduces the mucous membranes injury and enables to install a sponge of the required diameter without limitations, associated with anatomical features of organs, through which it is carried out, significantly increasing the effectiveness of vacuum therapy and reducing the period of medical and social rehabilitation of patients.;1 cl, 1 ex, 4 dwg