DYNAMICS OF INTESTINAL CONTENT FLUCTUATIONS ANASTOMOSED SMALL INTESTINE LOOPS AS MARKER IN DIAGNOSIS OF DUMPING SYNDROME OF DIFFERENT SEVERITY IN GASTRIC CANCER PATIENTS AFTER GASTRECTOMY

Abstract

The aim: to study the effectiveness of the method of daily fibroesophagoejunoscopy in determining the number of pellets of intestinal contents in the newly created anatomical-physiological complex and related functional disorders, accompanied by the manifestation of clinical symptoms of dumping syndrome of varying severity. Materials and methods. The method of fibrogastroscopic examination was by 190 patients with gastric tract after gastrectomy carried out. All patients were diagnosed with dumping syndrome of varying severity. The study showed that the severity of clinical manifestations of dumping syndrome depends on the number of intestinal contents in the newly created anatomical-physiological complex depending on the time of day. For proof of body, observing the stage, 30 patients underwent a modified esophagogastroscopic examination method, which was proposed by us – daily fibroeophagoeunoscopy, as well as histological and histochemical studies to detect inflammatory changes in anastomosed loops of the small intestine. To determine the dependence of clinical manifestations of dumping syndrome on the number of intestinal pellets, all patients underwent intracavitary intestinal laser therapy with helium-neon laser ULF-01. Results. When analyzing and comparing the data obtained during daily fibroesoeunoscopy with the clinical manifestations of dumping syndrome of varying severity, it was found, that at different periods of the day the intensity of intestinal casting in anastomosed loops of the small intestine and clinical manifestations of the disease differ significantly. It was established, that in the morning hours, at all degrees of severity of dumping syndrome, there was a minimum number of pellets of intestinal contents in the newly created anatomical complex and, accordingly, there were minimal clinical manifestations of the disease. The study also showed that the increase in clinical symptoms in patients with dumping syndrome is clearly precisely in the daytime manifested. Conclusions. The findings suggest that daily fibroesophagoeunoscopy is a pathognomonic method for diagnosing dumping syndrome in gastric cancer patients after gastrectomy. The method made it possible to establish that the severity of clinical manifestations depends on the number of casts of intestinal content and the time of its exposure in the newly created anatomical complex. The clinical symptoms of dumping syndrome are most in the daytime pronounced. The method also made it possible to determine that the most effective time for laser therapy is the morning period.