Comparative analysis of outcome predictors in patients with postoperative peritonitis depending on the method of surgical treatment – relaparotomy on demand vs vacuum-assisted laparostomy
| Autor: | I. B. Uvarov, D. D. Sichinava, A. M. Manuilov |
|---|---|
| Jazyk: | ruština |
| Rok vydání: | 2022 |
| Předmět: |
postoperative peritonitis
secondary peritonitis vacuum therapy laparostomy open abdomen relaparotomy on demand outcome predictors Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Diseases of the circulatory (Cardiovascular) system RC666-701 Surgery RD1-811 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 |
| Zdroj: | Инновационная медицина Кубани, Vol 0, Iss 4, Pp 24-31 (2022) |
| Druh dokumentu: | article |
| ISSN: | 2541-9897 |
| DOI: | 10.35401/2541-9897-2022-25-4-24-31 |
| Popis: | Background: Secondary postoperative diffuse peritonitis (SPDP) is one of the most severe complications of elective and emergency surgical interventions associated with a high mortality rate. To date, no optimal tactics of surgical treatment of SPDP has been developed.Objective: The analysis of independent predictors of outcome depending on the method of surgical treatment – relaparotomy ondemand (RD) or vacuum-assisted laparostomy (VAL).Material and methods: The study included 141 adult patients, male and female in the period from January 2014 to December 2020: group I (n = 63) – patients who received VAL method; group II (n = 78) – RD method. The method of multivariate logistic regression analysis was used to calculate the independent effects of potential predictor variables on the treatment outcome.Results: The following independent predictors of treatment outcome in the RD group were identified: age, duration of hospital stay, number of relaparotomies, APACHE II score, Björck classification grade 1C at the 1st sanitation, bacteremia, Clavien–Dindo complications class 3a and 4a. For the VAL group: conversion of surgical tactics and bacteremia.Conclusion: In patients with SPDP in the presence of risk factors for unfavorable outcomes, the use of VAL with staged sanitation of the abdominal cavity is indicated. |
| Databáze: | Directory of Open Access Journals |
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