N 4 (195) 2025. P. 46–50

PECULIARITIES OF THE FORMATION OF INTER-INTESTINALANASTOMOSES IN THE USE OF DAMAGE CONTROL SURGERY TACTICS

O. S. Herasymenko, M. A. Kashtalian, Ya. I. Haida, A. V. Okolets, Ie. A. Kvasnevskyi

Odesa National Medical University, Odesa, Ukraine
Military Medical Clinical Center of the Southern Region, Odesa, Ukraine

DOI 10.32782/2226-2008-2025-4-7

Introduction. Тhe incidence of small intestine injuries from gunshot wounds in the wars of the last century, as well as during the full-scale war in Ukraine, ranges from 21.1 to 42.1%, and the incidence of large intestine injuries – from 15.3 to 41.6%.

Objective of the study is to improve the results of treatment of wounded with small and large intestine injuries by improving surgical techniques for the formation of intestinal anastomoses.

A study of surgical treatment at the stages of medical evacuation of 148 wounded with combat abdominal trauma and damage to the small and large intestine was conducted. The wounded were divided into two groups: the main group (80) consisted of wounded who underwent restoration of intestinal integrity by forming a manual anastomosis. The second group, the control group (68), included wounded who underwent anastomosis formation by hardware, using the GIA TriStapler with DST Series Technology 60 mm.

At the third stage of DCS IV level of medical care, after stabilization of the wounded within 24–72 hours, an operation was performed to restore the integrity of the intestine by forming an anastomosis (in case of small intestine injuries). In case of colon injuries, preference was given to forming a terminal or preventive colostomy.

In the postoperative period, anastomotic failure in the control group occurred in 4.4%, compared to the main group – 2.5 %, which amounted to 3.4 % of the total.

Conclusions. In the formation of interintestinal anastomoses during the implementation of phase III of the DCS tactics, preference should be given to manual methods.

Keywords: combat abdominal trauma, intestinal anastomoses, “damage control surgery”.

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