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Year 2012 Vol. 20 No 3
GENERAL AND SPECIAL SURGERY
F.G. NAZYROV 1, A.V. DEVYATOV 1, D.SH. HODJIEV 2, A.H. BABADJANOV 1, R.YU. SADYKOV 3
OPTIMIZATION OF TREATMENT DIAGNOSING AND TACTICS OF THE ABDOMINAL CAVITY POSTOPERATIVE ABSCESSES
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.
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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
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.