«Профилактика несостоятельности желудочно-кишечных анастомозов в экстренной хирургии»

Summary 
of the dissertation work of Dzhumabekov Berik Nuraddinovich on the topic: 
«Prevention of gastrointestinal anastomosis failure in emergency 
surgery» 
for the degree of Doctor of Philosophy (PhD) in the specialty 
6D110100 – Medicine 
The relevance of the problem 
The incidence of intestinal anastomosis failure in emergency surgery, 
according to various authors, ranges from 6 to 40%, where the postoperative 
mortality rate can reach up to 40%. 
The main etiological factors in the development of this postoperative 
complication are considered to be: high intraluminal pressure, change in the 
functioning of the microcirculation of the intestinal wall, development of hypoxic 
changes in the tissues of the intestinal wall and formation of infectious processes in 
the peritoneal cavity with the participation of highly virulent microorganisms. 
Based on these factors, the correct choice of suture materials, increasing the 
mechanical strength and tightness of the anastomosis, as well as the use of existing 
methods of decompression and drainage of the intestinal lumen in the area of the 
anastomosis play an important role in the prevention of intestinal anastomosis 
failure. 
Auto-plasma is a natural source of signaling molecules; after platelet 
activation, their granules degranulate and release cytokines that modify the 
pericellular microenvironment. 
Today, the question of cellular response in relation to wound regeneration is 
becoming more and more popular. Platelets are the first type of blood cells 
responding to a wound and are also known to promote tissue repair through the use 
of growth factors and other active substances. 
The growth factors possessed by platelets are usually attributed to the group 
of polypeptide molecules. These molecules have different structures and have 
different mechanisms of action, which may be associated with different mitogenic 
and chemotactic properties. As you know, these properties are fundamental in 
wound healing. 
It should be noted that many experimental studies related to the 
determination of the strength of the formed intestinal anastomoses, to one degree 
or another, are based on the determination of the tensile strength with an increase 
in intra-intestinal pressure, however, in our opinion, the indicators of anastomosis 
regeneration should be supplemented by assessing the strength of the intestinal 
anastomosis based on morphometric indicators. 
Aim 
Improving the results of resection surgical interventions on the 
gastrointestinal tract in emergency surgery by using platelet-rich plasma and 
accelerating regeneration processes in the anastomosis zone. 

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