Immune Dysregulation and Early Recurrence in Adhesive Intestinal Obstruction: A Retrospective Study

Trends in Immunotherapy

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Immune Dysregulation and Early Recurrence in Adhesive Intestinal Obstruction: A Retrospective Study

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https://doi.org/10.54963/ti.v9i3.1343
Alymkulov, M., Mambetov, A., Uulu, E. S., Alanbaev, A., Mamatov, N., Abdiev, A., & Zhumabekova, A. (2025). Immune Dysregulation and Early Recurrence in Adhesive Intestinal Obstruction: A Retrospective Study. Trends in Immunotherapy, 9(3), 271–281. https://doi.org/10.54963/ti.v9i3.1343
Volume 9 Issue 3 (September 2025)
Copyright (c) 2025 Muratbek Alymkulov, Adyl Mambetov, Erbol Shamil Uulu, Aibek Alanbaev, Niazbek Mamatov, Allan Abdiev, Altynai Zhumabekova
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Authors

  • Muratbek Alymkulov

    Department of Hospital Surgery, Royal Metropolitan university, Bishkek 720010, Kyrgyzstan
  • Adyl Mambetov

    Department of Hospital and Operative Surgery named after academician M. Mamakeev, I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek 720020, Kyrgyzstan
  • Erbol Shamil Uulu

    Department of Hospital and Operative Surgery named after academician M. Mamakeev, I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek 720020, Kyrgyzstan
  • Aibek Alanbaev

    Department of Hospital and Operative Surgery named after academician M. Mamakeev, I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek 720020, Kyrgyzstan
  • Niazbek Mamatov

    Department of Hospital and Operative Surgery named after academician M. Mamakeev, I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek 720020, Kyrgyzstan
  • Allan Abdiev

    Department of Faculty Surgery named after academician K.R. Ryskulova, I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek 720020, Kyrgyzstan
  • Altynai Zhumabekova

    Department of Obstetrics and Gynecology, City Maternity Hospital No. 2, Bishkek 720007, Kyrgyzstan

Received: 24 June 2025; Revised: 30 July 2025; Accepted: 12 September 2025; Published: 26 September 2025

Adhesive intestinal obstruction (AIO) is a major complication of abdominal surgery, often leading to significant morbidity and a diminished quality of life. This study investigated the role of immune dysregulation in the development of early postoperative AIO and evaluated a multimodal strategy involving intraoperative lymphatic stimulation, mesenteric microirrigation, and immunoinflammatory biomarker monitoring to address adhesion-related complications in patients. This retrospective study included 38 patients who underwent surgery for acute AIO. Elevated levels of inflammatory markers, such as C-reactive protein, procalcitonin, interleukin-6, and tumor necrosis factor-alpha, have been observed in patients requiring reoperation due to early adhesion recurrence. Multivariable logistic regression analysis revealed that surgical history, adhesion severity, and elevated postoperative inflammatory markers were independent predictors of recurrence. Intraoperative lymphatic stimulation and postoperative mesenteric lavage with isotonic saline were performed to promote the removal of inflammatory mediators from the peritoneal cavity. Six of the seven patients who received this treatment showed symptom relief and decreased cytokine levels within 72 h. The study reported an early recurrence rate of 18.4% and a mortality rate of 2.6%. These findings suggest that monitoring inflammatory biomarkers after surgery could predict the risk of early adhesion recurrence, and employing a multimodal strategy targeting immune dysfunction during and after abdominal surgery may improve postoperative outcomes. The integration of immune-focused techniques, such as lymphatic stimulation and mesenteric lavage, could enhance standard surgical care by reducing inflammation and creating an environment that is less favorable for adhesion formation.

Keywords:

Adhesive Intestinal Obstruction Peritoneal Adhesions Mesothelial-to-Mesenchymal Transition Cytokines Immunomodulatory Strategies

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