Novosti
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This journal is indexed in Scopus |
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Year 2013 Vol. 21 No 4
GENERAL AND SPECIAL SURGERY
B.S. SUKOVATIH1, YU.YU. BLINKOV1, P.A. IVANOV2
THE COMBINED SURGICAL AND LAPAROSCOPIC TREATMENT OF THE GENERALIZED PERITONITIS
SBEE HPE “Kursk State Medical University” 1,
Regional Budgetary Medical Establishment "Municipal Clinical Emergency Hospital" 2, Kursk, The Russian Federation
Objectives. To improve the treatment results of patients with the generalized purulent peritonitis by optimizing video-laparoscopic technology of the abdominal cavity sanitation.
Methods. The results of the complex diagnostic examination and treatment of 90 patients with the generalized peritonitis have been analyzed. The first group included 49 patients who underwent the two-staged surgical treatment during the period of 2001-2006 years. At the first stage the patients were subjected to the surgical intervention, at the second stage in 24-48 hours after surgery the programmed video-laparoscopic sanitations of the abdominal cavity by the traditional technique have been performed. The aqueous sodium hypochlorite solution (0,03%) was used for the sanitation. The second group included 41 patients who were treated during the period of 2007-2012 years. The abdominal cavity was treated with the pulsating stream of antiseptic with addition of 200 ml of the immobilized form of sodium hypochlorite in 5% sodium carboxymethyl-cellulose gel during the endoscopic sanitation which is a distinctive feature of treatment method in the first group. The efficacy of treatment was evaluated according to the dynamics of the systemic endotoxicosis parameters, the degree of bacterial contamination of the abdominal cavity, the severity of violations of the bowel motor-evacuation function, the number of postoperative complications and mortality rate.
Results. At hospitalization the abdominal sepsis without the signs of multiple organ failure has been detected in all patients. The use of the original technique of the abdominal cavity sanitation lets to reduce the indicators of endotoxemia in 1,5 folds in the recent post-operative period, improve bowel evacuation function in 2 folds. The number of the recent postoperative complications has decreased by 16,8% and the mortality rate decreased by 9,4%.
Conclusion. The combined surgical and endoscopic method of treatment of peritonitis is pathogenetically substantiated and effective.
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305041, Rossiiskaia Federatsiia, g. Kursk, ul. K. Marksa, d. 3, GBOU VPO «Kurskii gosudarstvennyi meditsinskii universitet», kafedra obshchei khirurgii,
e-mail: SukovatykhBS@kursksmu.net,
Sukovatykh Boris Semenovich
Sukovatih B.S. MD., professor, a head of the general surgery chair of SBEE HPE “Kursk State Medical University”.
Blinkov Yu.Yu. PhD, An associate professor of the general surgery chair of SBEE HPE “Kursk State Medical University”.
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