PATHOGENETIC PREREQUISITES FOR THE DEVELOPMENT OF THE ADHESION PROCESS OF THE ABDOMINAL CAVITY

Abstract

In the literature, there is a discussion concerning the prevention, diagnosis and treatment of adhesions of the abdominal cavity and associated with intestinal obstruction, while the question of the pathogenesis of the disease and the true reasons for its development is completely overlooked. Recently, there have been no any significant achievements in solving this problem. The analysis of literature sources revealed a number of shortcomings of the scientific and practical approach associated with outdated fundamental ideas about the causes of the adhesive process, which are based on tissue oxygenation and fibrin organization. So, the healing of the peritoneum and the restoration of the native layer of mesioteliocetes without the formation of adhesions is possible only in the first 3 days from the moment of an injury. At the same time, hypoxia plays an important role in the formation of peritoneal adhesions, affecting the maturation of mesothelial cells and the differentiation of fibroblasts. The solution to the problem of adhesion is possible by influencing the key links of pathogenesis: hypoxia in the abdominal tissue, the system of fibrinolytic and extracellular matrix degradation, the formation and activation of autocoids and regulators of fibrotic tissue. Despite the traditionally established approaches, it is necessary to revise the concept of the pathogenicity theory understanding the cellular and molecular mechanisms of adhesion formation .