Historical paradigms in the treatment of patients with adhesive intestinal obstruction

Adhesive disease of the abdominal cavity is an urgent and completely unresolved problem in modern surgery. The first mentions of intestinal obstruction have been known to history since ancient times. The first and fundamental stage in the study of adhesive disease is the empirical period, the beginning of which dates back to the 17th century. During this period, there was an unsystematic accumulation of knowledge; scientists and surgeons put forward theories and assumptions about the causes of adhesions. The next historical period in approaches to the treatment of patients with intestinal obstruction of adhesive origin is the period of active surgical tactics. With the increase in surgical activity in the heyday of surgery since the end of the 19th century, the increase in patients with adhesive disease of the abdominal cavity is inextricably linked, and as a result, a disease such as intestinal obstruction, the cause of which was intraperitoneal adhesions, became widespread. At the end of the 20th century, endovideosurgery became very popular and widespread in surgery. Laparoscopic adhesiolysis had a number of important advantages compared with open surgery. Thus, the next historical stage in the treatment of patients with adhesive intestinal obstruction was the preference for laparoscopic surgical techniques. Currently, the surgical community is inclined to change the paradigm in the treatment of patients with adhesive disease, which consists of minimizing the surgical component in the treatment of patients in this group with an emphasis on a conservative approach, as well as paying attention to the prevention of adhesive disease. Currently, both in foreign and domestic literature, one can find a colossal amount of work on the search for new therapeutic and diagnostic techniques, the use of methods for preventing adhesions, and a comparative analysis of already known treatment algorithms. However, today there is no consensus on the tactics of managing patients with adhesive intestinal obstruction, which requires further study of the problem and finding ways to solve it.

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