Year 2019 Vol. 27 No 4

REVIEWS

V.P. ZEMLYANOI 1, B.V. SIGUA 1, S.V. PETROV 2, V.A. IGNATENKO 2, P.A. KOTKOV 2

SURGICAL TREATMENT OF PATIENTS WITH TERTIARY PERITONITIS

North-Western State Medical University named after I.I. Mechnikov 1,
St. Petersburg State Health Care Institution "Elizabethan Hospital" 2, Saint-Petersburg,
The Russian Federation

The problems of tertiary peritonitis treating are described in a large amount of scientific papers covering various aspects of this disease. The analysis of the literature shows an increased frequency of persistent peritonitis among patients of surgical units and the lack of unified approaches to its treatment. The diagnostic criteria of tertiary peritonitis are extremely non-specific, which makes it difficult to work out an effective treatment program. This article focuses on adequate sanitation of the abdominal cavity as one of the main therapeutic components. The use of planned and on demand relaparotomies was introduced into clinical practice long ago, however, no clear indications for the use of specific operational tactics were found in the available literature. A comparative assessment is given to different ways of abdominal cavity managing (open, closed, half-open, half-closed). The main ways of operative injury minimizing, that inevitably accompanies repeated surgical interventions and leads to the development of abdominal complication, are considered. Obviously, the problem of tertiary peritonitis is far from its final decision, and further scientific research aimed at surgical approaches upgrade should help to improve the results of treatment.

Keywords: tertiary peritonitis, planned relaparotomy, laparostomy, on demand relaparotomy, sanitation of the abdominal cavity
p. 453-460 of the original issue
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Address for correspondence:
191015, The Russian Federation,
Saint Petersburg, Kirochnaya Str., 41,
North-Western State Medical
University named after I.I. Mechnikov,
Department of the Faculty Surgery named after I.I. Grekov.
Tel. +790626192131,
e-mail: kotkovdr@mail.ru
Pavel A. Kotkov
Information about the authors:
Zemlianoi Viacheslav P., MD, Professor, Head of the Department of the Faculty Surgery named after I.I. Grekov, North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russian Federation.
https://orcid.org/0000-0003-2329-0023
Sigua Badri V., MD, Professor of the Department of the Faculty Surgery named after I.I. Grekov, North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russian Federation.
https://orcid.org/0000-0002-4556-4913
Petrov Sergey V., MD, Professor, Chief Physician of St. Petersburg State Health Care Institution Elizabethan Hospital, Saint Petersburg, Russian Federation.
https://orcid.org/0000-0003-4398-5770
Ignatenko Viktor A., Head of the Surgical Unit 2, St. Petersburg State Health Care Institution Elizabethan Hospital, Saint Petersburg, Russian Federation.
https://orcid.org/0000-0002-6615-3005
Kotkov Pavel A., PhD, Surgeon of the Surgical Unit2, St. Petersburg State Health Care Institution Elizabethan Hospital, Saint Petersburg, Russian Federation.
https://orcid.org/0000-0002-9762-9854
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