Methodology for assessing the severity of diffuse peritonitis and prognosis of relaparotomy

INTRODUCTION. The problem of treating patients with peritonitis has always been and still remains relevant in surgery. Moreover, aspects of treating patients with tertiary peritonitis requiring repeated interventions are of particular importance. The OBJECTIVE of this work was to develop and evaluat...

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Main Authors: B. V. Sigua, V. P. Zemlyanoy, S. V. Petrov, V. A. Ignatenko, P. A. Kotkov
Format: Article
Language:Russian
Published: Pavlov First Saint Petersburg State Medical University 2021-08-01
Series:Вестник хирургии имени И.И. Грекова
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Online Access:https://www.vestnik-grekova.ru/jour/article/view/1576
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author B. V. Sigua
V. P. Zemlyanoy
S. V. Petrov
V. A. Ignatenko
P. A. Kotkov
author_facet B. V. Sigua
V. P. Zemlyanoy
S. V. Petrov
V. A. Ignatenko
P. A. Kotkov
author_sort B. V. Sigua
collection DOAJ
description INTRODUCTION. The problem of treating patients with peritonitis has always been and still remains relevant in surgery. Moreover, aspects of treating patients with tertiary peritonitis requiring repeated interventions are of particular importance. The OBJECTIVE of this work was to develop and evaluate the clinical effectiveness of a score-prognostic scale that allows to identify groups of patients with a high risk of persistent surgical infection in the abdominal cavity, in which a single intervention cannot be considered effective even despite the elimination of the primary surgical infection focus.METHODS AND MATERIALS. To achieve the goal, a correlation was evaluated between a number of factors and the likelihood of relaparotomy in a retrospective group consisting of 111 patients with secondary peritonitis. Based on the achieved data, score-prognostic scale for assessing the severity of peritonitis was developed, which allowed to formulate an algorithm of surgical tactics, which was used in the treatment of 109 patients. A group of 34 people with a high risk of tertiary peritonitis development was allocated from the number of patients – of which 20 patients had a total number of 39 planned surgical interventions.RESULTS. The use of the developed scale led to an increase in the total number of surgical interventions, however, reducing postoperative mortality by 1.7 times (p = 0.001) mainly due to improved survival rates in the group of patients with severe forms of peritonitis.CONCLUSION. The obtained results allowed to recommend the developed integral prognostic scale for assessing the severity of peritonitis for use in clinical practice.
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spelling doaj-art-0fb06a0985014d5baaf5f9fdce19b32a2024-11-26T10:43:55ZrusPavlov First Saint Petersburg State Medical UniversityВестник хирургии имени И.И. Грекова0042-46252021-08-011802212710.24884/0042-4625-2021-180-2-21-271226Methodology for assessing the severity of diffuse peritonitis and prognosis of relaparotomyB. V. Sigua0V. P. Zemlyanoy1S. V. Petrov2V. A. Ignatenko3P. A. Kotkov4North-Western State Medical University named after I. I. MechnikovNorth-Western State Medical University named after I. I. MechnikovNorth-Western State Medical University named after I. I. MechnikovNorth-Western State Medical University named after I. I. MechnikovNorth-Western State Medical University named after I. I. MechnikovINTRODUCTION. The problem of treating patients with peritonitis has always been and still remains relevant in surgery. Moreover, aspects of treating patients with tertiary peritonitis requiring repeated interventions are of particular importance. The OBJECTIVE of this work was to develop and evaluate the clinical effectiveness of a score-prognostic scale that allows to identify groups of patients with a high risk of persistent surgical infection in the abdominal cavity, in which a single intervention cannot be considered effective even despite the elimination of the primary surgical infection focus.METHODS AND MATERIALS. To achieve the goal, a correlation was evaluated between a number of factors and the likelihood of relaparotomy in a retrospective group consisting of 111 patients with secondary peritonitis. Based on the achieved data, score-prognostic scale for assessing the severity of peritonitis was developed, which allowed to formulate an algorithm of surgical tactics, which was used in the treatment of 109 patients. A group of 34 people with a high risk of tertiary peritonitis development was allocated from the number of patients – of which 20 patients had a total number of 39 planned surgical interventions.RESULTS. The use of the developed scale led to an increase in the total number of surgical interventions, however, reducing postoperative mortality by 1.7 times (p = 0.001) mainly due to improved survival rates in the group of patients with severe forms of peritonitis.CONCLUSION. The obtained results allowed to recommend the developed integral prognostic scale for assessing the severity of peritonitis for use in clinical practice.https://www.vestnik-grekova.ru/jour/article/view/1576diffuse peritonitisrelaparotomylaparostomasurgical infection of the abdominal cavityprogram sanitationprognostic scale
spellingShingle B. V. Sigua
V. P. Zemlyanoy
S. V. Petrov
V. A. Ignatenko
P. A. Kotkov
Methodology for assessing the severity of diffuse peritonitis and prognosis of relaparotomy
Вестник хирургии имени И.И. Грекова
diffuse peritonitis
relaparotomy
laparostoma
surgical infection of the abdominal cavity
program sanitation
prognostic scale
title Methodology for assessing the severity of diffuse peritonitis and prognosis of relaparotomy
title_full Methodology for assessing the severity of diffuse peritonitis and prognosis of relaparotomy
title_fullStr Methodology for assessing the severity of diffuse peritonitis and prognosis of relaparotomy
title_full_unstemmed Methodology for assessing the severity of diffuse peritonitis and prognosis of relaparotomy
title_short Methodology for assessing the severity of diffuse peritonitis and prognosis of relaparotomy
title_sort methodology for assessing the severity of diffuse peritonitis and prognosis of relaparotomy
topic diffuse peritonitis
relaparotomy
laparostoma
surgical infection of the abdominal cavity
program sanitation
prognostic scale
url https://www.vestnik-grekova.ru/jour/article/view/1576
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AT svpetrov methodologyforassessingtheseverityofdiffuseperitonitisandprognosisofrelaparotomy
AT vaignatenko methodologyforassessingtheseverityofdiffuseperitonitisandprognosisofrelaparotomy
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