Features of debridement at the diffuse peritonitis
Abstract
Aim of investigation. Improvement of results of surgical treatment of patients with the diffuse peritonitis by repeated programmed interventions method on the basis of finalization criteria.
Materials and methods. Results of 87 cases with diffuse peritonitis underwent statistical analysis. On the basis of obtained data prognostic system of evaluation of the programmed debridement was designed. The system included the most indicative intraabdominal features observed at the next debridement, and severity of general state and multiorgan failure.
Results. Original system was utilized at treatment of 23 patients. This resulted in decrease of number of «ondemand» operations from 18,4 to 8,7%. Diagnostic sensitivity of system was 91,3%, diagnostic efficacy – 90%, diagnostic specificity – 90,7%.
Conclusions. Premature finalization of program of repeated debridements occurs quite frequently in surgical practice at treatment of diffuse peritonitis. Performance of «on-demand» operations has negative effect on prognosis and increases mortality in this group. Original integrated prognostic system of evaluation of the programmed debridement allows reliable planning of abdominal debridement cycle duration and to prove its termination with high probability level.
About the Authors
S. G. Shapoval’yantsRussian Federation
A. A. Lindenberg
Russian Federation
I. P. Marchenko
Russian Federation
K. B. Lummer
Russian Federation
S. S. Sogreshilin
Russian Federation
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Review
For citations:
Shapoval’yants S.G., Lindenberg A.A., Marchenko I.P., Lummer K.B., Sogreshilin S.S. Features of debridement at the diffuse peritonitis. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2009;19(3):46-50. (In Russ.)
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