TREATMENT OF MESENTERIC THROMBOSIS IN THE ASPECT OF EARLY THROMBECTOMY FROM MESENTERIC ARTERY

The article presents analysis of Russian and foreign sources devoted to medical treatment of acute mesenteric thrombosis using thrombectomy both as a separate method of treatment and in a combination with laparotomy. Nowadays this disease is characterized by high level of mortality due to absence of a clear plan of treatment, difficulties in diagnosis, late referral for medical assistance, high prevalence of cardiovascular diseases and other somatic pathologies along with predomination of elderly people in morbidity pattern. Acute mesenteric thrombosis is included in the group of pathophysiological processes that can lead to intestinal gangrene, which results in peritonitis with subsequent intoxication of the body, sepsis and death. Acute bowel ischemia rapidly progresses to necrosis – irreversible state associated with metabolic disorders, leading to multiorgan failure. With untimely treatment, surgeons are faced with the task of extensive intestinal resection, which undoubtedly reduces the quality of patients' life. It is also possible to transfer these patients to lifelong parenteral nutrition, which will obligatorily lead to cachexia. The method of early thrombectomy is used in acute frustration of mesenteric circulation caused by occlusion of mesenteric artery. Thrombectomy can be used not only as an independent treatment among other endovascular interventions, but also in a combination with laparotomy in cases of transition of the disease to subcompensation stage. Of not less importance for maintaining a positive effect of the operation is the postoperative rehabilitation period. During this period, the patient should obligatorily follow recommendations of the attending doctor. In order to prevent rethrombosis, anticoagulants of direct and indirect action should be used. In case of changes in the stable condition of the patient in the postoperative period, it is required to make diagnosis to exclude rethrombosis, and if the results are not good, diagnostic laparoscopy should be conducted.