Medical complications after restorative surgery in patients with colostomy after colon resection
Therapeutic pathology occupies a significant place in the structure of complications after recovery operations that follow the obstructive colon resections. Reduced trauma intervention is one of the areas of prevention of complications. Therapeutic complications during recovery operations that were performed using local and median access in 161 patients with the regional anesthesia in the postoperative period were studied. 1 (0.6 %) patient died due to acute heart failure. Operation made using local laparotomy in 71 (44.1 %) patients, and using median access in 90 (55.90 %), among them 35 (38.88 %) were carried out epidural anesthesia. Therapeutic complications occurred in 20 (12.42 %) patients. According to the classification Dindo-Clavien the complications were treated as degree 1 in 6 patients, as degree 2 in 13, and as degree 5 in 1 patient. Medical complications were associated with exacerbation of chronic disease in 17 (85 %) patients, the primary pathology without prior history was observed in 3 (15 %) patients. In 4 (20 %) patients the acute somatic pathology after recovery operations were similar complications after obstructive resection. Study of frequency of somatic complication depending on surgical access shows that after parastomal laparotomy they were in 5 (7.04 %) patients, and after median access in 15 (16.66 %). The incidence of systemic diseases was studied in 35 patients with restoration of bowel continuity, that were operated using midline laparotomy with continuous epidural anesthesia, and in 55 patients operated using median access without regional anesthesia. The number of somatic complications in patients undergoing regional anesthesia - 4 (11.42 %) was less than in patients operated without regional anesthesia - 11 (20 %). The inplementation of interventions for comorbidities when resistant compensation, application of local access and prolonged epidural anesthesia reduces the amount of physical complications during recovery operations after obstructive colon resection.