Intraoperative intestinal viability assessment in acute bowel obstruction

Aim. To improve the results of surgical treatment of acute bowel obstruction by introducing a new device and a method for intraoperative assessment of intestinal viability and further choice of resection and enteroenteroanastomosis level.

Methods. Our team has designed a new device for checking the arterial blood hemoglobin oxygen saturation, pulse rate, perfusion and intramural pressure in intestinal wall. A novel method for checking peripheral blood circulation was used for choosing the resection level during the surgery and for enteroenterostomy in 50 patients of the main group. Suture line viability index was also calculated using the formula proposed by M.R. Ramazanov (2008), suture line arterial blood hemoglobin oxygen saturation was also determined. Control group included 44 patients, in whom intestinal resection and enteroenterostomy for acute bowel obstruction were performed without examining the peripheral blood circulation before the device was introduced.

Results.Intramural pressure in bowel obstruction area in 10 patients was significantly lower (48.4±0.6/36.3±0.6 mm Hg at arterial blood pressure of 120.2±0.8/80±0.6 mm Hg) compared to the similar parameter in 15 healthy patients (86.5±0,9/60.3±0,5 mm Hg, p

Conclusion. The developed device allows to adequately access the peripheral blood flow in bowel obstruction, intestinal viability index and arterial blood hemoglobin oxygen saturation might be used in bowel obstruction to specify the intestinal resection level during surgery.