ASSESSMENT OF RISK FACTORS FOR DEVELOPMENT OF INCOMPETENCE OF INTERINTESTINAL ANASTOMOSES: LITERATURE REVIEW

Despite numerous scientific studies in the given field, the problem has not yet been solved and remains highly relevant. There is no unanimous opinion in the literature on methods for diagnosis and prevention of such a serious complication as anastomotic leakage (AL). The pathological processes leading to an anastomotic defect are diverse, interrelated and poorly studied, and therefore the frequency of AL remains high today. The timely diagnosis of anastomosis leakage in a patient in the postoperative period is rather difficult. The absence of preventive measures, impossibility of using conservative and minimally invasive treatment methods in the later stages lead to the development of threatening postoperative complications and to the necessity of repeated surgical interventions in conditions of peritonitis, up to the separation of the interintestinal anastomosis, 50% of which, according to the world literature data, cannot be closed, and the formation of the terminal stoma. On the other hand, it is worth to mention an increase in the incidence of local recurrence and a delay in use of adjuvant chemotherapy and radiation therapy in patients with colorectal cancer who underwent septic complications due to the incompetence of the anastomosis and the development of peritonitis. As it is known, sepsis leads to disorders in the immune system, and with the underlying suppression of the immune system the probability for development of the local recurrences and progression of the disease in the form of long-term metastasis increases. Results. Awareness of all risk factors and of their interrelations permits to forecast the risk of incompetence of the intestinal anastomoses and on this basis to develop further tactics to prevent this complication without repeated surgical intervention. This permits not only to avoid fatal consequences, but also to improve the quality of life of the patient, to reduce duration of stay in the hospital in case of a favorable course of the postoperative period, and also to reduce financial costs.