The first results of a comparative analysis of the use of vacuum-assisted laparostomy and planned relaparotomy in patients with widespread purulent peritonitis as a result of urgent pathology and abdominal trauma

Abstract

Background. Тhe problem of treating widespread purulent peritonitis and abdomi nal sepsis remains one of the most urgent in surgery. The use of vacuum-assisted laparostomy creates prerequisites for improving the treatment results of this group of patients. Conducting research in this direction is relevant and justified. The aim. To conduct an initial comparative analysis of the effectiveness of vacuum laparostomy and planned relaparotomy in widespread purulent peritonitis and ab dominal sepsis. Materials and methods. The study consisted of retrospective (17 patients with planned relaparotomy) and prospective (7 patients with vacuum-assisted laparostomy) parts, in which two options for stage-by-stage treatment of patients with widespread purulent peritonitis complicating the course of urgent abdominal pathology and abdominal trauma were compared. Results. When using vacuum laparostomy in comparison with planned relapa rotomy, the duration of treatment increases both in the intensive care unit (14.0 days [12.0; 15.0] vs. 4.0 days [2.0; 4.0]; p < 0.01) and in the hospital (36.0 days [20.5; 39.5] vs. 11.0 days [7.0; 17.0]; p < 0.01), more relaparotomies are required (p < 0.01), while the mortality rate decreases, albeit statistically insignificantly (14.3 % vs. 35.3 %; p = 0.625). Conclusion. Conducting systematic reviews and meta-analyses based on ran domized clinical trials will provide data of a higher level of evidence and grade of recommendations.

Keywords

• widespread purulent peritonitis
• abdominal sepsis
• vacuum-assisted laparostomy
• planned relaparotomy