Intensive therapy in patients with scar strictures of the esophagus

• Main Authors: V. O. Shaprynskyi, Y. V. Shaprynskyi, V. F. Kryvetskyi, Mustafa Bassam Hussein
• Format: Article
• Language: Russian
• Published: Interdisciplinary Academy of Pain Medicine 2018-05-01
• Series: Perioperative Medicine
• Subjects: scar esophageal strictures; medical tactics; intensive care
• Online Access: https://perioperative.org.ua/index.php/prtmdc/article/view/8

The proposed medical tactics and intensive therapy of scar strictures of the esophagus we represent in this article. The causes of their occurrence: burns in the esophagus, surgical interventions on the esophagus, reflux esophagitis, and malignant genesis – esophageal cancer. A considerable part of patients with scar strictures of the esophagus is hospitalized at later stages of the stricture: with 4th and 5th degrees of obstruction. This leads to increasing of the number of exhausted patients and neglected cases, that contributes to increasing of levels of postoperative lethality and complications. The sults of surgical treatment of 116 patients with esophageal strictures at the period of 2003–2017 were analyzed. We used a logistic regression method to determine the risk factors for postoperative complications. It was established that the risk increases significantly with the presence of technical difficulties during operation, diabetes mellitus, blood plasma albumin levels less than 25 g/l, complete obstruction of the esophagus. The proposed program of treatment of patients with scar strictures of the esophagus reliably reduces the risk of postoperative complications. The diagnostic algorithm, the program of treatment of patients with preoperative infusion therapy and parenteral nutrition with “all in one” system were applied in patients of the main group. Due to the treatment program and intensive therapy, the number of postoperative complications has decreased from 27,27% to 12,0%, and mortality – from 6,06% to 2,0%.