Open Management of the Abdomen and Planned Reoperations in Severe Bacterial Peritonitis
| Autor: | Th. J. M. V. van Vroonhoven, P. F. Hulstaert, Koop Bosscha, Maarten R. Visser, Chr. van der Werken |
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| Rok vydání: | 2000 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Time Factors Multiple Organ Failure medicine.medical_treatment Bacterial Peritonitis Perforation (oil well) Peritonitis Anastomosis Severity of Illness Index Abdominal wall Laparotomy Abdomen medicine Humans Hospital Mortality Aged Retrospective Studies Aged 80 and over business.industry Retrospective cohort study Bacterial Infections Middle Aged medicine.disease Surgery Treatment Outcome medicine.anatomical_structure Surgical Procedures Operative Female Morbidity business Follow-Up Studies |
| Zdroj: | The European Journal of Surgery. 166:44-49 |
| ISSN: | 1102-4151 |
| DOI: | 10.1080/110241500750009690 |
| Popis: | Objective. To assess the results of open management of the abdomen and planned re-operations in severe bacterial peritonitis after perforation or anastomotic disruption of the digestive tract. Design. Retrospective study. Setting. University Hospital, The Netherlands. Subjects: 67 consecutive patients. Interventions: Open management of the abdomen and planned reoperations. Main outcome measures: Hospital morbidity and mortality, long-term follow-up. Results: 38 patients developed multiple organ failure (MOF), but 29 needed only ventilatory and inotropic support. The mean number of re-operations was nine. 16 patients developed severe bleeding and 16 fistulas. In-hospital mortality was 42% (n = 28). Long-term morbidity, particularly the number of abdominal wall defects (n = 10), was considerable. Conclusion. Despite open management of the abdomen and planned re-operations, mortality of severe bacterial peritonitis still continues to be too high, and both short and long-term morbidity are appreciable. The value of open management of the abdomen and planned re-operations rests only on the clinical observation that other conventional surgical treatments of severe bacterial peritonitis often fail. |
| Databáze: | OpenAIRE |
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