mossjМосковский хирургический журналMoscow Surgical Journal2072-3180ООО «ПРОФИЛЬ – 2С»mossj-22Research ArticleСтатьиВОПРОСЫ ПАТОГЕНЕЗА СПАЕЧНОЙ БОЛЕЗНИ БРЮШИНЫ И СОВРЕМЕННЫЕ ПОДХОДЫ К ЕЕ ПРЕДУПРЕЖДЕНИЮ. ОБЗОР ЛИТЕРАТУРЫЛуцевичО. Э.oleglutsevich@gmail.comАкимовВ. П.akimov.spbmapo@mail.ruШиринскийВ. Г.vlad-liga@rambler.ruБичевА. А.alexanderbichev@gmail.comГБОУ ВПО Московский государственный медико-стоматологический университет имени А.И. ЕвдокимоваRussian FederationСеверо-Западный государственный медицинский университет имени И.И.МечниковаRussian Federation201731072020031126Copyright © Луцевич О.Э., Акимов В.П., Ширинский В.Г., Бичев А.А., 20202020Луцевич О.Э., Акимов В.П., Ширинский В.Г., Бичев А.А.Луцевич О.Э., Акимов В.П., Ширинский В.Г., Бичев А.А.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.mossj.ru/jour/article/view/22

Послеоперационные спайки по-прежнему представляют собой нерешенную проблему. В настоящее время поиск надежных средств профилак- тики послеоперационного спаечного процесса движется по пути использования разнообразных барьерных противоспаечных средств, поскольку они обладают очевидными преимуществами перед лекарственными средствами. Однако, развитие спаечного процесса обусловлено множеством значимых этиологических и влияющих факторов, и барьерные средства способны лишь уменьшить действие некоторого ряда из них. Другим суще- ственным препятствием в преодолении данной проблемы авторы считают отсутствие единой формальной системы оценки выраженности спаечной болезни брюшины, так как существующие индивидуальные оценочные подходы не позволяют сравнивать параметры эффективности между тем или иным способом предотвращения спаечного процесса. В представленном обзоре детально рассмотрены достоинства и недостатки некоторых используемых в практике барьерных средств. По мнению авторов, основа успешного решения проблемы спаек состоит в сочетании качественной хирургической техники вмешательства с методами предупреждения скрытых повреждений брюшины и интраоперационной инстилляцией поли- компонентного противоспаечного барьерного геля, выбор которого основан на доказанной в строгих клинических испытаниях эффективности.

Postoperative peritoneal adhesions are unsolved problem still. Currently, a thorough search of reliable postoperative adhesion prevention measures is going on a way of various adhesion barrier application due to the obvious advantages of the latter versus drugs. However, the adhesion formation is conditioned by a multitude of significant etiological and influencing factors, and adhesion barriers are enable to diminish only the effect of some of them. The authors consider the absence of the unified formal scale estimation system of adhesion extent classification as another essential obstacle to overcoming the present problem because the existing individual estimation methods do not admit the comparison of effectiveness indices between certain anti-adhesion methods. In the present review, advantages and limitations of some practically applied barriers were observed. According to the authors, the basis of the successful solution of the mentioned problem lies in the coupling of applied surgical intervention technique quality with anticipating methods of hidden peritoneum damages and with intra- operating poly-component anti-adhesion barrier gel instillation. The choice of that kind barrier gel is ought to be done on a base of rigorous clinical trials results of a high evidence level.

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The authors declare that there are no conflicts of interest present.