Choice of laparoscopic approach and treatment results for diffuse appendicular peritonitis

Сажин, А. В.; Ивахов, Г. Б.; Titkova, S.; Ermakov, Igor V.; Nechay, T V; Мосин, С. В.

doi:10.17116/endoskop2020260215

Cited by 2 publications

(4 citation statements)

References 18 publications

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“…Научно-технический прогресс в медицине сопровождается широким применением лапароскопических технологий в диагностическом и лечебном процессах. Их использование позволило существенно уменьшить количество напрасной лапаротомии [6][7][8].…”

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“…В некоторых работах отмечено, что наложение пневмоперитонеума у пациентов с перитонитом повышает эффективность лечения и приводит к лучшим клиническим результатам, в т.ч. сокращению длительности операции, снижению интраоперационной кровопотери и показателей послеоперационной боли, а также уменьшению продолжительности пребывания пациентов в стационаре [14,15].…”

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“…Основными негативными сторонами лапароскопического вмешательства при перитоните, по мнению различных авторов, могут быть невозможность полноценной адекватной санации брюшной полости при её массивной бактериальной контаминации и множественных плотно фиксированных фибринозных наложениях на висцеральной брюшине, плохой обзор брюшной полости при наличии паралитической кишечной непроходимости, отсутствие возможности осуществить назоинтестинальную декомпрессию [15,16]. Кроме того, рядом исследователей отмечено, что время проведения лапароскопического вмешательства является более длительным по сравнению с открытым [15][16][17].…”

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“…Алгоритм лечения пациентов должен быть персонифицированным и учитывать ряд параметров, в т.ч. опыт уровень владения лапароскопической техникой, материально-техническое оснащение лечебного учреждения [14,15].…”

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Laparoscopy for Acute Peritonitis

Salakhov,

Vlasov,

Rubtsov

et al. 2023

Ulyanovsk Medico-biological Journal

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Peritonitis is the most serious complication of urgent abdominal diseases, associated with high mortality rates (up to 13 %). The main component for complex peritonitis treatment is surgery. In some cases, it is carried out in several stages, that contributes to complete abdominal cavity sanitation. The choice of surgical treatment (laparotomy / laparoscopy) is made individually, taking into account a number of parameters: the objective patient status, the clinical course of the disease, the material and technical equipment of the medical institution and the professional surgical skills. It has been noted that laparoscopy for peritonitis, in contrast to laparotomy, is more sparing in terms of surgical access. Laparoscopy and laparotomy significantly reduce complications in the postoperative period, including wound complications and postoperative hernias. As a result, inpatient treatment decreases, and a better cosmetic effect is achieved. However, the advisability of laparoscopy for patients with complex clinical manifestations of acute peritonitis remains a highly controversial issue.

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Laparoscopy for Acute Peritonitis

Salakhov,

Vlasov,

Rubtsov

et al. 2023

Ulyanovsk Medico-biological Journal

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Laparoscopic Appendectomy in the Treatment of Patients with Complicated Acute Appendicitis

Malkov,

Mamedov,

Filippov

et al. 2024

Neotložnaâ med. pomoŝʹ

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Relevance Treatment of complicated forms of acute destructive appendicitis continues to be an urgent problem in emergency abdominal surgery. Aim of study Improving the results of surgical treatment of patients with appendiceal peritonitis with laparoscopic appendectomy.Material and methods A retrospective analysis of the treatment of 150 patients with acute appendicitis complicated by local and diffuse peritonitis aged from 17 to 69 years was carried out. There were 77 (51.3%) women and 73 (48.7%) men. Depending on the treatment tactics used, two groups of patients were divided. In the main group (64 patients), the leading treatment method was laparoscopic appendectomy. In the comparison group (86 patients), traditional approaches were used, including open appendectomy with the McBurney approach in 72 patients (83.7%) and laparotomy for diffuse peritonitis in 14 (16.4%).Results The analysis of the surgical techniques used showed that in the main group, wound postoperative complications developed in 9 patients (14.1%). In the comparison group, postoperative complications developed in 32 patients (37.2%). For local nonlimited peritonitis, the total duration of hospitalization after laparoscopic appendectomy performed in 49 patients was 6.7±1.4 days, and 8.6±2.1 days (p<0.05) in 72 patients who underwent open appendectomy. The duration of hospitalization was 8.2±2.7 days in case of diffuse peritonitis after laparoscopic appendectomy, sanitation and drainage of the abdominal cavity (15 cases), and 12.4±1.3 days (p<0.05) in 14 patients after laparotomy, appendectomy, sanitation and drainage of the abdominal cavity, intubation of the small intestine.Conclusion Laparoscopic appendectomy may be the operation of choice for complicated forms of acute appendicitis according to developed indications. It should be performed by a surgeon experienced in endosurgical operations. To increase the efficiency of washing the abdominal cavity in case of diffuse peritonitis, it is recommended to use hardware sanitation. The capabilities of laparoscopic appendectomy make it possible to adequately perform the required amount of surgical treatment, minimize surgical trauma, and significantly reduce the rate of postoperative complications and the duration of hospital treatment compared to open appendectomy.

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Choice of laparoscopic approach and treatment results for diffuse appendicular peritonitis

Cited by 2 publications

References 18 publications

Laparoscopy for Acute Peritonitis

Laparoscopy for Acute Peritonitis

Laparoscopic Appendectomy in the Treatment of Patients with Complicated Acute Appendicitis

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