Undifferentiated dysplasia of connective tissue in patients with insufficiency of anastomotic sutures of the gut hollow organs

Abstract

Objective. Improvement of results of treatment in patients, suffering insufficiency of anastomotic sutures in the gut hollow organs, using determination of role for the connective tissue undifferentiated dysplasia (CTUD) in development of this complication, estimation of the phenomena spreading and elaboration of informative criteria for the CTUD diagnosis. Маterials and methods. Retro- and prospective trial was based on data about 42 patients, suffering insufficiency of anastomotic sutures, who were treated in the National Institute of Surgery and Transplantology named after О. О. Shalimov of NAMS of Ukraine, and 20 practically healthy persons (the comparison group), comparable for age and gender with the investigated patients. The procalcitonin of the blood serum and C-reactive protein analysis were used for special laboratory investigation. The status of the connective tissue metabolism was estimated in accordance to content of free oxyprolene in the blood serum and the level of glycosaminoglycans in urine. Results. There was revealed, that the most informative phenotypical markers of CTUD in patients, suffering insufficiency of anastomotic sutures of the gut hollow organs, are visceral (78.6%), vascular (73.8%) and arythmical (54.7%) syndromes. There was established, that direct correlation between the level of biochemical markers of the collagen biodegradation and the CTUD degree may be applied for prognostication of development and course of complications in patients, suffering insufficiency of the anastomotic sutures of the gut hollow organs. Severe degree of CTUD in the patients, suffering insufficiency of interintestinal anastomoses, complicated by extended peritonitis, constitutes unfavorable prognostic sign and enhances the mortality by 87.5%. Conclusion. The presence of CTUD in the patients, suffering insufficiency of anastomotic sutures of the gut hollow organs constitutes the unfavorable factor of comorbidity, which must be taken into account, choosing the adequate surgical tactics and complex pathogenetically substantiated treatment.

Keywords

• undifferentiated dysplasia of connective tissue; insufficiency of anastomotic sutures; phenotypical and biochemical markers; diagnostic criteria