Optimization of pharmaceutical therapy of erosive and ulcerative lesions of the gastroduodenal zone in elective surgical patients
https://doi.org/10.24884/0042-4625-2025-184-2-86-93
Abstract
The objective was to improve the results of treatment of surgical patients in the perioperative period with concomitant erosive and ulcerative lesions of the gastroduodenal zone.
Methods abd materials. 41 patients receiving inpatient care were observed from March to December 2024. The results of the study were registered for the following stages: 1 – the control before prescribing the drug, 2 – after 3–5 days of therapy with Omeprazole/Lanson-AF. All patients included in the study were assessed at stages 1 and 2 according to the dynamics of the main general clinical and biochemical laboratory parameters and the results of fibrogastroduodenoscopy (FGDS). Statistical data processing was performed using the IBM SPSS Statistics 20 program.
Results. According to FGDS data, defects of the gastroduodenal mucosa of varying severity were detected in patients at the 1st stage of the study. After the 1st stage, patients were divided into 2 groups: control and comparison. Antisecretory therapy with Omeprazole was performed in the control group, and Lanson-AF was performed for 3–4 days in the comparison group. In the control FGDS, there was a decrease in hyperemia, edema, and the absence of a visible defect in the gastric and/or duodenal mucosa. With Omeprazole, ulcerative defect repair was achieved by 3–4 days in 40 % of patients, with Lanson-AF in 92 % of cases.
Conclusion. The appointment of the drug Lanson-AF is more effective than Omeprazole for the purpose of preoperative preparation of patients with defects of the gastric and/ or duodenal mucosa for elective surgery. No adverse events have been reported with the use of Lanson-AF.
About the Authors
A. V. KuliginRussian Federation
Kuligin Aleksandr V., Dr. of Sci. (Med), Associate Professor, Head of the Department of Emergency Medicine, Anesthesiology and Intensive Care and Simulation Technologies in Medicine, Chief Freelance Specialist in Anesthesiology and Intensive Care in the Saratov Region, Saratov State Medical University n. a. V. I. Razumovsky
137, Bolshaya Sadovaya str., Saratov, 410054
K. A. Ershova
Russian Federation
Ershova Karina A., 2nd year Resident specializing in Anesthesiology and Intensive Care of the Department of Emergency Medicine, Anesthesiology and Intensive Care and Simulation Technologies in Medicine, Resident Physician
137, Bolshaya Sadovaya str., Saratov, 410054
A. E. Polozhenkov
Russian Federation
Polozhenkov Aleksandr E., 1st year Postgraduate Student of the Department of Emergency Medicine, Anesthesiology and Intensive Care and Simulation Technologies in Medicine, Anesthesiologist and Intensivist
137, Bolshaya Sadovaya str., Saratov, 410054
R. S. Prokhorov
Russian Federation
Prokhorov Roman S., Head of the Department of Anesthesiology and Intensive Care № 2 of the University Clinical Hospital № 1 named after S. R. Mirotvortsev (Clinical Center)
137, Bolshaya Sadovaya str., Saratov, 410054
M. S. Yakovenko
Russian Federation
Yakovenko Maria S., Cand. of Sci. (Med), Associate Professor of the Department of Therapy № 1 of the Faculty of Advanced Training and Professional Retraining of Specialists, Honored Healthcare Worker of the Kuban, Gastroenterologist of the Highest Category, Head of the Department
167, Pervogo Maya str., Krasnodar, 350086
A. V. Borota
Russian Federation
Borota Alexandr V., Dr. of Sci. (Med), Professor, Head of the Department of General Surgery № 1, Donetsk State Medical University named after M. Gorky, Head of the Proctology Department,
14, Ilyich ave., Donetsk, Donetsk People’s Republic, 28300
N. K. Ibragimov
Uzbekistan
Ibragimov Nematzhon K., Cand. of Sci. (Med), Associate Professor, Head of the Department of Anesthesiology and Intensive Care
2, Farabi str., Tashkent, 100109
A. A. Sheptulin
Russian Federation
Sheptulin Arkady A., Dr. of Sci. (Med), Professor of the Department of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology
8, Trubetskaya str., building 2, Moscow, 119048
References
1. Lu R., Yang B. Incidence and influencing factors of acute gastrointestinal injury after cardiac surgery. BMC Cardiovasc Disord. 2023;(23):437. https://doi.org/10.1186/s12872-023-03475-6
2. Kutukov V. V., Zaitsev I. V., Dzhanibekova Д. E. Prevention of acute erosions and ulcers of esophagus and stomach after oncologic operations on kidneys. Eurasian Union of Scientists. 2016;(4–3(25)):115–117. (In Russ.). EDN XCMGID.
3. Kostyuchenko M. V. Acute erosive-ulcerous lesions of the stomach at surgical endotoxicosis and methods of their prophylaxis. Medical Alphabet. 2016;1(5: Practical gastroenterology):41–45. (In Russ.).
4. Gurusamy K. S., Pallari E. Medical versus surgical treatment for refractory or recurrent peptic ulcer. Cochrane Database of Systematic Reviews. 2016;(3):CD011523. https://doi.org/10.1002/14651858.CD011523.pub2.
5. Clarke K., Adler N., Agrawal D et al. Indications for the Use of Proton Pump Inhibitors for Stress Ulcer Prophylaxis and Peptic Ulcer Bleeding in Hospitalized Patients. Am J Med. 2022;(Is.135, № 3):313–317. https://doi.org/10.1016/j.amjmed.2021.09.010.
6. Kaigorodtseva N. V., Plotkin L. L., Sagidullin А. V. et al. Efficacy of a new proton pump inhibitor in patients in critical condition. Bulletin of Chelyabinsk Regional Clinical Hospital. 2024;59(1):2–3. (In Russ.).
7. Kostina A. A., Kulakova D. A., Aksenova T. A. Proton pump inhibitor drugs: the problem of choice. International Student Scientific Bulletin. 2021;(2):172. (In Russ.).
8. Saade M. C., Kerbage A., Jabak S. et al. Validation of the new ABC score for predicting 30-day mortality in gastrointestinal bleeding. BMC Gastroenterol. 2022;(22):301. https://doi.org/10.1186/s12876-022-02374-y
Review
For citations:
Kuligin A.V., Ershova K.A., Polozhenkov A.E., Prokhorov R.S., Yakovenko M.S., Borota A.V., Ibragimov N.K., Sheptulin A.A. Optimization of pharmaceutical therapy of erosive and ulcerative lesions of the gastroduodenal zone in elective surgical patients. Grekov's Bulletin of Surgery. 2025;184(2):86-93. (In Russ.) https://doi.org/10.24884/0042-4625-2025-184-2-86-93