Algorithm of surgical treatment of postoperative peritonitis

Abstract

Objective. To improve the results of surgical treatment in patients with postoperative peritonitis, using the certain algorithm proposed. Materials and methods. Prospective investigation was conducted on 244 patients, suffering postoperative peritonitis (the main group). In accordance to the peritoneal affection size the restricted postoperative peritonitis was present in 125 (51.2%) patients, and the extended one – in 119 (48.8%). Retrospective investigation consisted of studying of 212 cards of stationary patients, operated for postoperative peritonitis (the control group). Results. Miniinvasive operative reinterventions were done in 114 (46.7%) patients, suffering postoperative peritonitis, of them in 55 (48.2%) laparoscopic sanation and drainage of the peritoneal cavity abscess was used. In 19 (55.9%) of 34 patients with postoperative peritonitis in the interloop abscesses a laparoscopic sanation and drainage of the abscess were performed. Open operative interventions were performed in 130 (53.3%) patients. Conclusion. Application of the elaborated algorithm of the postoperative peritonitis surgical treatment have permitted to reduce the patients stationary stay from (14.2 ± 1.6) bed–days (control group) to (10.6 ± 1.2) bed–days (main group) and to reduce the lethality level from 31.6% (control group) to 18.4% (the main group).

Keywords

• postoperative peritonitis
• algorithm of surgical treatment