Year 2012 Vol. 20 No 3




The Republican specialized surgical center named after academician V. Vakhidov1, Tashkent
Ministry of Health of the Republic of Karakalpakstan2
Karakalpakstan affiliate of the Republican scientific center of emergent medical aid3, Nukus
The Republic of Uzbekistan

Objectives. To improve treatment results of the postoperative abdominal abscesses by optimizing early diagnosing and treatment strategy.
Methods. The analysis of the repeated interventions in 88 patients with the abdominal cavity abscesses after the initial emergency and planned operations carried out in various hospitals of the Republic of Uzbekistan was carried out.
Results. The performed analysis has shown that in the structure of all intraabdominal complications, the limited purulent formations after emergency surgery make up 4,0-12,7% and 9,9-15,2% after planned operations. Depending on the severity of systemic inflammatory response syndrome (SIRS), mortality rate after the repeated interventions for these complications amounts to 25,6-33,3% at average SIRS and 63,2-66,7% at severe SIRS. Taking into account the results of research the tactical algorithm to select the optimum treatment strategy of the postoperative abdominal abscesses has been proposed.
Conclusions. The best option for the standardization of protocols of this category of patients is the use of integrated prognostic scales, summation results of which let adequately to assess the risk of a repeated surgical intervention and thus optimize the choice of the treatment tactics. The practical value of the waked out algorithm permits to determine the risk of relaparotomy and, accordingly, to optimize the surgical tactics in relation to urgency and the choice of an adequate amount of the alleged interference, which will significantly improve the results of surgical treatment for these patients.

Keywords: abdominal surgery, postoperative abdominal abscesses, repeated operations
p. 48 54 of the original issue

1. Guseinov SA. Diagnostika i lechenie posleoperatsionnykh abstsessov briushnoi polosti, vyzvannykh neklostridial'noi anaerobnoi infektsiei [ [Diagnosis and treatment of postoperative abdominal abscesses caused by non-clostridial anaerobic infection]. Ann Khirurgii. 1999;(4):7880.
2. Zavernyi LG. Poida AI, Mel'nik VM, Nadeev SS. Chastota i diagnostika vnutribriushnykh abstsessov v rannem posleoperatsionnom periode [The frequency and diagnosis of intra-abdominal abscesses in the early postoperative period]. Vestn Khirurgii. 1993;150(3-4):12326.
3. Vadala G, Caragliano V., Castorina R., Caragliano L. An update in the treatment of intra-abdominal abscesses. Minerva Chir. 1999;54(4):24550.
4. Zhebrovskii VV. Rannie i pozdnie posleoperatsionnye oslozhneniia v khirurgii organov briushnoi polosti: prakt ruk. [Early and late postoperative complications in surgery of the abdominal cavity: a guidance]. Simferopol', Ukraine: KGMU; 2000. 688 p.
5. Bufalari A, Giustozzi G, Moggi L. Postoperative intraabdominal abscesses: percutaneous versus surgical treatment. Acta Chir Belg. 1996;96(5):197200.
6. Kumar RR. Kim JT, Haukoos J.S., Macias L.H.. Factors affecting the successful management of intraabdominal abscesses with antibiotics and the need for percutaneous drainage. Dis Colon Rectum. 2006 Feb;49(2-P):18389.
7. Solov'ev GM, Bagdasarov VV, Kazarova EA, Karapetian MM. Povtornoe chrevosechenie posle ekstrennykh operatsii [Re-laparotomy after emergency surgery]. Ann Khirurgii. 1999;(6):10911.
8. Ziubritskii NM, Semko NM. Ob oslozhneniiakh posleoperatsionnykh vnutribriushnykh abstsessov [On complications of postoperative intraabdominal abscesses]. Klin Khirurgiia. 1986;(1):1820.
9. Grigorian RA. Relaparotomiia v khirurgii zheludka i dvenadtsatiperstnoi kishki [Relaparotomy in surgery of the stomach and duodenum]. Moscow, RF: MIA; 2005. 400 p.
10. Y, Yapp SK. Laparoscopic drainage of postoperative complicated intra-abdominal abscesses. Surg Laparosc Endosc Percutan Tech. 2000;10(5):31113.
11. Men S, Akhan O, Koroglu M. Percutaneous drainage of abdominal abscess. Eur J Radiol. 2002;43(3):20418.
12. Saleem M, Ahmad N, Ahsan I. Ultrasound guided percutaneous drainage of abdominal abscesses. J Med Assoc. 2000;50(2):5053.

Address for correspondence:
100115, Respublika Uzbekistan, g. Tashkent, ul. Farkhadskaia, d. 10, Respublikanskii spetsializirovannyi tsentr khirurgii im. akad. V.Vakhidova, otdelenie khirurgii portal'noi gipertenzii i pankreatoduodenal'noi zony,
Babadzhanov Azam Khasanovich
Information about the authors:
Nazyrov F.G., Doctor of Medicine, Professor, Director of the Republican Specialized Center of Surgery named after Academician V.Vakhidov.
Devyatov A.V., Doctor of Medicine, Professor, Chief Researcher of the Department of Surgery of Portal Hypertension and the Pancreaticoduodenal Zone of the Republican Specialized Center of Surgery named after Academician V.Vakhidov.
Hohjiev D.Sh., Candidate of Medical Sciences, Minister of Health of the Republic of Karakalpakstan.
Babadjanov A.H., Candidate of Medical Sciences, Senior Researcher of the Department of Surgery of Portal Hypertension and the Pancreaticoduodenal Zone of the Republican Specialized Center of Surgery named after Academician V.Vakhidov.
Sadikov R.Yu., an Ordinator of the Department of Surgery of the Karakalpak Affiliate of the Republican Scientific Center for Emergency Medical Care.
Contacts | ©Vitebsk State Medical University, 2007-2023