THE EFFECT OF PROPHYLACTIC NEGATIVE PRESSURE WOUND THERAPY COMPARED WITH STANDARD METHODS OF LAPAROTOMY WOUND CLOSURE IN PATIENTS WHO UNDERWENT OPEN SURGERY FOR COLORECTAL CANCER

Abstract. Endoluminal vacuum therapy (ENDO-VAC) is an effective method of treating partial failure of colorectal anastomoses. Its use allows to avoid radical surgical intervention, reduce the risk of septic complications and accelerate the healing process of the anastomosis. The aim of the study. To assess the effectiveness and determine the adequacy of the indications for the use of ENDO-VAC in partial failures of colorectal anastomoses after operations for colorectal cancer. Materials and methods. The study used the results of treatment of patients with colorectal cancer who underwent surgical treatment with restoration of the continuity of the gastrointestinal tract on the basis of the oncosurgical department of the Regional Oncology Center of the State Educational Institution of Ukraine in the period 2021–2024. Inclusion criteria: diagnosed colorectal cancer; surgical treatment without the formation of a colostomy or ileostomy; partial failure of the colorectal anastomosis ( 50% of the semicircle of the intestine); absence of signs of generalized peritonitis. Diagnosis of anastomotic leak was carried out using: clinical blood test; determination of C-reactive protein and procalcitonin levels; MSCT with contrast per os/per rectum; videocolonoscopy. Patients with confirmed anastomotic leak in the absence of signs of peritonitis were installed with a vacuum-assisted system, which was changed until a positive result was achieved. Results and their discussion. During the study period, 564 patients were operated on, of which 28 (4.96%) cases were diagnosed with anastomotic failure. 18 patients underwent ENDO-VAC, the rest received repeated surgical intervention. The average time for diagnosis of anastomotic leak was the 8th day (3-13 days after surgery). The average duration of endoscopic treatment was 22 days (4-43). Patients who required parenteral nutrition were 6/18 (33.33%). Patients who received intravenous antibiotic therapy – 8/18 (44.44%). Patients who required radical surgery due to ineffectiveness of ENDO-VAC – 1/18 (5.56%). Overall efficacy of ENDO-VAC – 17/18 (94.44%). ENDOVAC demonstrated high efficacy in stable patients, preventing the need for permanent stoma creation and improving overall treatment outcomes. Conclusions. Endoluminal vacuum therapy appears to be effective for the treatment of colorectal anastomotic leakage, especially when used as the primary treatment for fistula. Long-term functional outcome of patients undergoing conservative treatment of anastomotic leakage can be improved with endoluminal vacuum therapy.