Pathogenetic approach in correction of homeostasis disorders in comorbid urgent pathology of the abdomen associated with diabetes mellitus 

Aleksey P. Vlasov, Doctor of medical sciences, professor, head of the sub-department of faculty surgery with courses in topographic anatomy and operative surgery, urology and pediatric surgery, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), E-mail: vap.61@yandex.ru
Nina Yu. Leshchankina, Doctor of medical sciences, associate professor, professor of the sub-department of hospital therapy, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), E-mail: bream25@yandex.ru
Darya G. Sardaeva, Applicant of the sub-department of normal and pathological physiology, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), E-mail: mak1233@yandex.ru
Ruslan R. Kazakov, Applicant of the sub-department of faculty surgery, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), E-mail: kazakov.rus.raf@yandex.ru
Ekaterina V. Veshkina, Applicant of the sub-department of faculty therapy, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), E-mail: vtlbwbyf_79@mail.ru 

Background. Until now, urgent pathology of the abdomen remains in the focus of attention in modern abdominal surgery, which is due to the preservation of a high level of morbidity and mortality. Therefore, it is relevant to search for treatment regimens to optimize the results of treatment, especially in comorbid pathology with diabetes mellitus. The purpose of the study is to establish the effectiveness of metabolic and laser therapy in the correction of homeostasis and microcirculation disorders in the early postoperative period in patients with comorbid urgent pathology of the abdomen with diabetes mellitus. Materials and methods. 38 patients with acute abdominal diseases complicated by peritonitis and diabetes mellitus of both types were studied: the first (n=20) – treatment of patients according to clinical recommendations; the second (n=18) – complex treatment included laser therapy and remaxol. The patients have been operated on. Observation stages 1, 3 and 5 days after surgery. The microcirculation, the level of toxins, the severity of oxidative stress and the activity of phospholipase A2 were evaluated. Results. It was found that in patients who underwent surgical interventions for acute surgical pathology of the abdomen, having diabetes mellitus, significant phenomena of endogenous intoxication occurred in the early postoperative period, which was accompanied by phenomena of oxidative stress and increased phospholipase activity. Patients in the early postoperative period had significant microcirculation disorders. In the group of patients whose treatment included laser therapy and remaxol, homeostasis and microcirculation disorders were less pronounced. It turned out that the number of complications in patients who occurred in the early postoperative period, assessed according to the Clavien-Dindo classification, decreased by 34.7% (p<0.05), the stay of patients in the hospital was reduced by 2.12 bed-days (p<0.05). Conclusion. The use of laser therapy and remaxol in the complex treatment of patients with urgent abdominal diseases with diabetes mellitus has shown high efficiency. With this kind of therapy, the main pathogenetic components of the presented comorbid pathology are affected, on which the course of the early postoperative period and the development of complications directly depend. 

Urgent abdominal diseases, diabetes mellitus, microcirculation, oxidative stress, remaxol, laser 

Vlasov A.P., Leshchankina N.Yu., Sardaeva D.G. Kazakov R.R., Veshkina E.V. Pathogenetic approach in correction of homeostasis disorders in comorbid urgent pathology of the abdomen associated with diabetes mellitus. Izvestiya vysshikh uchebnykh zavedeniy. Povolzhskiy region. Meditsinskie nauki = University proceedings. Volga region. Medical sciences. 2024;(2):167–178. (In Russ.). doi: 10.21685/2072-3032-2024-2-15