THE USE OF ANTI-ADHESION DRUGS IN PREGNANT WOMEN WITH STRANGULATED POSTOPERATIVE HERNIAS AND ACUTE ADHESIVE SMALL INTESTINALL OBSTRUCTION

Adhesion disease of the peritoneum is one of the difficult and unsolved problems of surgery. The number of patients is constantly increasing, which is due to the increase in the number and volume of surgical interventions on the organs of the abdominal cavity. Aim. The study aimed to investigate and compare the outcomes of treatment in pregnant women with peritoneal adhesions following emergency surgical interventions, where adhesiolysis was performed and hyaluronic acid was used. Materials and methods. Between 2012 and 2024, 80 pregnant women aged 21 to 42 years with adhesive disease underwent adhesiolysis and were included in the study. The patients were divided into four groups: 1) Control Group: 20 patients who received urgent surgical treatment, adhesiolysis, and conservative management using standard protocols for strangulated postoperative hernias; 2) Second Group: 20 patients who underwent surgical intervention for strangulated ventral hernias and adhesiolysis with the application of hyaluronic acid; 3) Third Group: 20 patients who underwent urgent enterolysis without the use of hyaluronic acid for acute adhesive small intestinal obstruction; 4) Fourth Group: 20 patients who underwent urgent enterolysis with the application of hyaluronic acid for acute adhesive small intestinal obstruction. For statistical analysis, the following methods were used: the Mann-Whitney U coefficient, the correlation coefficient (r), Spearman's rank correlation coefficient (rho), and Confidence Intervals. Statistical analysis was performed using the MedCalc program, version 23.0.2 Results. In the second group, following surgical interventions and the application of hyaluronic acid, favorable short-term and long-term outcomes were observed, with a follow-up period extending up to 6 years. However, in the fourth group of patients who underwent urgent enterolysis with the use of the drug, an improvement in short-term results was noted, although the long-term outcomes were nearly indistinguishable from those in the third group. Conclusions. The study confirmed the efficacy of hyaluronic acid in treating adhesions during surgical procedures for postoperative hernias. However, its effectiveness was not observed in emergency surgeries for acute adhesive intestinal obstruction. Superior outcomes can be attained through a comprehensive approach to the prevention and management of peritoneal adhesive disease, incorporating the use of modern and innovative anti-adhesion agents.