OBSTRUCTIVE ILEOSTOMY IN TREATMENT OF COMPLEX LARGE INTESTINE FISTULA

A.A. Baulin¹, O.A. Baulina¹, N.V. Baulina², Sh.O. Darbishgadzhiev¹, V.A. Baulin¹

¹Department of Surgery, Oncology and Endoscopy named after Professor N. A. Baulin, Penza Institute for Advanced Training of Doctors – Branch of Russian Medical Academy of Continuing Postgraduate Education, Penza, Russia
²Department of Obstetrics and Gynecology, Penza State University, Penza, Russia

The causes of the development of complicated large intestine fistulas can be: tactical and technical errors allowed in both surgical intervention and in the management of the postoperative period, as well as the presence in the abdominal cavity at the time of the pyoinflammatory process. The article presents two clinical cases of successful treatment of complex large intestine fistulas of the colon according to the author’s method. The authors developed a variant of obstructive ileostomy for the treatment of complex large intestine fistulas. A distinctive feature of the method is the complete exclusion of intestinal contents from the passage through the critical zone, which allows achieving positive results in the treatment of complex fistulas of the large intestine and colonic insufficiency. When choosing a method of treatment, in particular, an operational benefit in patients with intestinal fistulas should take into account not only the localization of the process but also its prevalence, the presence of complications. An important factor in the choice of tactics is the age of the patient, as well as the presence of concomitant diseases. The effectiveness of treatment, including surgical, depends on early diagnosis and the application of rational tactics of subsequent intervention. The application of a modified obstructive ileostomy can be used in patients with complex large intestine fistulas.

Keywords: Large intestine fistula, large intestine anastomosis, inconsistency, obstructive ileostomy.

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