Effect of operation technic on development of postoperative complications after appendectomy

Abstract

Objective: to improve the results of treatment of patients with acute appendicitis. Te results of surgical treatment of 360 patients with acute appendicitis were presented.Materials and methods: in predicting of development of intra-abdominal adhesions in patients afer appendectomy and of effectiveness of anti-adhesion therapy in postoperative period was used clinical, laboratorial (phenotype signs of connective tissue dysplasia syndrome, activity of the enzyme N-acetyltransferase, a test system based on sorbents with magnetic properties with immobilized granular antigen from adhesive tissue), instrumental methods of research. Te frst group included 120 (50%) patients who underwent standard appendectomy. In 120 patients with acute appendicitis (the second group) the elements of “Fast-Track” surgery was used in performing classical laparotomy appendectomy. Te third group consisted of 120 patients who underwent laparoscopic appendectomy.Results: all patients with diagnosed adhesive process in the early stages of its development in postoperative period were provided with anti-adhesion therapy. Te least number of postoperative complications was observed in cases of multimodal approach to treatment of acute appendicitis.Conclusions: application of “Fast-Track” surgery principles allowed to reduce development of intra-abdominal adhesion afer surgery compared with traditional appendectomy on 6.6 %, and with laparoscopic — on 2.8 %.

Keywords

• acute appendicitis
• prognosis
• prevention
• intra-abdominal adhesion
• treatment.