Authors
Singaevsky A.B., Lugovoy A.L., Yartseva E.A., Grebtsov Yu.V., Agishev I.A.
Federal state budgetary educational institution of higher education «North-Western state University named after I. I. Mechnikov» of the Ministry of health of the Russian Federation, St. Petersburg
Abstract
Despite the progress and successes of modern surgery, postoperative peritonitis remains a significant problem, the relevance of which has not decreased in recent years. The seriousness of the situation is indicated by the fact that sepsis, which develops in 41,7–78,3% of cases of postoperative peritonitis, contributes to an increase in mortality to 60% or more. Timely diagnosis and treatment of postoperative peritonitis currently continues to be a serious and not completely solved problem in abdominal surgery. According to domestic authors, the incidence of postoperative peritonitis reaches 7–9%. According to domestic and foreign literature, even modern methods of instrumental diagnosis do not allow to confidently diagnose the progression of postoperative peritonitis, as a result of which 16–25% of patients perform «belated» reoperations, and 0,6–7% of patients perform «vain» reoperations. The same clinical symptoms, for example, such as intestinal paresis, can occur both in the normal and pathological course of the postoperative period. Mortality in postoperative peritonitis reaches 29–64%. Currently, the results of diagnosis and treatment of patients with postoperative peritonitis have been significantly improved due to the introduction of endovideosurgical techniques, but still this issue remains unresolved.
Keywords: peritonitis, endovideosurgery, sanitation, relaparoscopy, relaparotomy.
References
1. Peritonit i endotoksinovaya agressiya. Ed by V.S. Savel’ev, V.A. Petukhov. Moscow: Meditsina; 2012. 326 p. (In Russ).
2. Kovalenko AA, Veselov YuE, Levin LA, et al. Mortality structure in acute stomach nosolocical group and the role of endovideosurgical technique in its decrease. Vestnik Sankt-Peterburgskogo universiteta. Meditsina. 2007;(3):80–95. (In Russ).
3. Sukovatykh BS, Blinkov IuIu, Bukreeva AE, et al. Treatment of the diffuse septic peritonitis. Khirurgiia (Mosk). 2012;(9):42–47. (In Russ).
4. Klimovich IN, Maskin IA, Dubrovin AM, et al. Endovideosurgery in the diagnosis and treatment of postoperative peritonitis. Vestn Khir Im I I Grek. 2015;174(4):113–116. (In Russ).
5. Makushkin RZ, Baichorov EKh, Khatsiev BB, et al. Repeated surgical operations for disseminated purulent peritonitis. Khirurgiia (Mosk). 2009;(11):18–22. (In Russ).
6. Podachin PV. Etapnye reoperatsii v khirurgii rasprostranennogo peritonita. [dissertation] Moscow; 2014. (In Russ). Available at: https://www.dissercat.com/content/etapnye-reoperatsii-v-khirurgii-rasprostranennogo-peritonita.
7. Peritonit. Ed by V.V. Rybachkov, K.V. Kostyuchenko, S.V. Maevskii. Yaroslavl: YarMediaGrup; 2010. (In Russ).
8. Salakhov EK. Novye laparoscopicheskie tekhnologii v lechenii bolnikh ostrym peritonitom. [dissertation] Saransk; 2014. 19 p. (In Russ). Available at: http://www.dslib.net/xirurgia/novye-laparoskopicheskie-tehnologii-v-lechenii-bolnyh-ostrym-peritonitom.html.
9. Sedov VM, Izbasarov RZh, Strizheletsky VV, et al. Programmed sanation laparoscopy in treatment of peritonitis. Vestn Khir Im I I Grek. 2008;167(1):88–91. (In Russ).
10. Drăghici L, Drăghici I, Ungureanu A, et al. Laparoscopic surgery complications: postoperative peritonitis. J Med Life. 2012;5(3):288–296.
11. Dunne N, Booth MI, Dehn TC. Establishing pneumoperitoneum: Verres or Hasson? The debate continues. Ann R Coll Surg Engl. 2011;93(1):22–24. doi: 10.1308/003588411X12851639107557.
12. Huang JC, Yeh CC, Hsieh CH. Laparoscopic management for Seprafilm-induced sterile peritonitis with paralytic ileus: report of 2 cases. J Minim Invasive Gynecol. 2012;19(5):663–666. doi: 10.1016/j.jmig.2012.04.006.
13. van Ruler O, Kiewiet JJ, van Ketel RJ, et al. Initial microbial spectrum in severe secondary peritonitis and relevance for treatment. Eur J Clin Microbiol Infect Dis. 2012;31(5):671–682. doi: 10.1007/s10096-011-1357-0.
14. Swank HA, Mulder IM, Hoofwijk AG, et al. Early experience with laparoscopic lavage for perforated diverticulitis. Br J Surg. 2013;100(5):704–710. doi: 10.1002/bjs.9063.
15. Pokrovskii EZh, Stankevich AM, Kon’kov OI, et al. Possibilities of videolaparoscopic sanation of abdominal cavity for secondary generalized peritonitis. Endoskopicheskaya khirurgiya. 2010;16(1):13–15. (In Russ).
16. Sukovatykh BS, Blinkov YuYu, Blinkov YuA, Ivanov PA. Efficacy of combined surgical and endoscopic means of diffuse peritonitis treatment. Vestn Khir Im I I Grek. 2013;172(4):24–28. (In Russ).
17. Malkov IS, Salakhov EK. Laparoscopic sanitation of the abdominal cavity in the complex treatment of patients with advanced peritonitis. Kazan medical journal. 2012;93(2):287–289. (In Russ).
18. Shapovalants SG, Timofeev ME, Fedorov ED, et al. Application of videolaparoscopic procedures in patients with generalized peritonitis (technique and results). Endoscopic surgery. 2013;19(2):3–14. (In Russ).
19. Ates M, Coban S, Sevil S, Terzi A. The efficacy of laparoscopic surgery in patients with peritonitis. Surg Laparosc Endosc Percutan Tech. 2008;18(5):453–456. doi: 10.1097/SLE.0b013e31817f4624.
20. Mandala V, editor. The role of laparoscopy in emergency abdominal surgery. Italy: Springer — Verlag; 2012. 207 p. doi: 10.1007/978-88-470-2327-7.
21. Ruttinger D, Kuppinger D, Holzwimmer M, et al. Acute prognosis of critically ill patients with secondary peritonitis: the impact of the number of surgical revisions, and of the duration of surgical therapy. Am J Surg. 2012;204(1):28–36. doi: 10.1016/j.amjsurg.2011.07.019.
22. Planovaya posleoperatsionnaya videolaparosokpiya v kompleksnom lechenii rasprostranennogo peritonita. Proceedings of the 2nd Congress Assotsiatsii khirurgov im. N.I. Pirogova “Aktual’nye problemy i perspektivy razvitiya endokhirurgii”; Sankt-Peterburg, 24-28 Jun 1998. St. Petersburg: Man and health; 1998. P. 15–17. (In Russ).
23. Lau WY. Perforated peptic ulcer: open versus laparoscopic repair. Asian J Surg. 2002;25(4):267–269. doi: 10.1016/S1015-9584(09)60190-1.
24. Bertleff M, Halm JA, Bemelman WA, et al. Randomized clinical trial of laparoscopic versus open repair of the perforated peptic ulcer: the LAMA Trial. World J Surg. 2009;33(7):1368–1373. doi: 10.1007/s00268-009-0054-y.
25. Alekberzade AV, Krylov NN, Rustamov EA, et al. Perforated peptic ulcer closure: laparoscopic or open? Khirurgiia (Mosk). 2017;(2):45–50. (In Russ). doi: 10.17116/hirurgia2017245-50.
26. Sanabria AE, Morales CH, Villegas MI. Laparoscopic repair for perforated peptic ulcer disease. Cochrane Database Syst Rev. 2005;(4):CD004778.doi: 10.1002/14651858.CD004778.pub2.
27. Beburishvili AG, Mikhin IV, Vorobiev AA Vypolnenie laparoskopicheskikh vmeshatel’stv u ranee operirovannykh bol’nykh. In: Proceedings of the VII Russian congress of endoscopic surgeons; Moscow, 24-28 February 2009. Moscow: UP Print; 2009. P. 204–205. (In Russ).
28. Fedorov IV, Chugunov AN, Valiullin IN. Prevention of trocars complications in laparoscopy. Endoscopic surgery. 2009;15(6):54–58. (In Russ).
29. Lutsevich OE, Gallyamov AA, Sinkov AA. Endoscopic treatment of peritonitis. In: Proceedings of the 1st Congress of Moscow surgeons “Emergency and specialized surgical care”; Moscow, 17-18 May 2005. Moscow; 2005. P. 148–149. (In Russ).
30. Gallyamova SV, Shirinsky VG, Gallyamov EA, et al. Complications during difficult endosurgical operations: current status. Endoscopic surgery. 2008;14(1):34–36. (In Russ).
31. Collient P, Ballester M, Fauconnier A, et al. [Risks associated with laparoscopic entry. (In French).] J Gynecol Obstet Biol Reprod (Paris). 2010;39(8 Suppl 2):S123–135. doi: 10.1016/S0368-2315(10)70039-9.
32. Shayani-Nasab H, Amir-Zargar MA, Mousavi-Bahar SH, et al. Complications of entry using Direct Trocar and/or Veress Needle compared with modified open approach entry in laparoscopy: six-year experience. Urol J. 2013;10(2):861–865.
33. Vishnevskaya AN, Stegniy KV, Rapkova VG. Laparoscopy in diagnosing and treating post-operative peritonitis. Pacific medical journal. 2011;(1); 34–36. (In Russ).
34. Tomnyuk ND, Danilina EP, Chernykh AN, et al. Peritonitis as one of the causes of death. Sovremennye naukoemkie tekhnologii. 2010;(10):81–84. (In Russ).
35. Sazhin IV, Sazhin VP, Bronstein PG, et al. Laparoscopic treatment of perforated ulcers. Khirurgiia (Mosk). 2014;(7):12–16. (In Russ).
36. Tekelioglu UY, Erdem A, Demirhan A, et al. The prolonged effect of pneumoperitoneum on cardiac autonomic functions during laparoscopic surgery; are we aware? Eur Rev Med Pharmacol Sci. 2013;17(7):895–902.
37. Makarov AA, Kasum’ian SA, Solov’ev VI, Abramenkova IV. Technical support and technical peculiarities of gasless laparoscopy. Endoscopic surgery. 2009;15(6):51–53. (In Russ).
38. Karelina NV. «Bezgazovaya» laparoskopiya v lechenii zhelchno-kamennoi bolezni. [dissertation] Velikiy Novgorod; 2009. 123 p. (In Russ). Available at: https://www.dissercat.com/content/bezgazovaya-laparoskopiya-v-lechenii-zhelchnokamennoi-bolezni.
39. Patent RUS № 2193864/2001 Davliev MK, Chugunov AN. Sposob podgotovki patsienta k laparoskopicheskomu vmeshatel’stvu i ustroistvo dlya ego osushchestvleniya. (In Russ). Available at: http://www.freepatent.ru/patents/2169528.
40. Patent RUS № 2150230/2000 Lobakov AI, Gringauz VB, Zakharov YuI, Fomin AM. Sposob posleoperatsionnoi laparoskopicheskoi sanatsii bryushnoi polosti pri razlitom gnoinom peritonite. (In Russ). Available at: https://findpatent.ru/patent/215/2150230.html.
41. Baranov GA, Brontvein AT, Kharlamov BV. Negative effects of pneumoperitoneum in minimally invasive operations. Proceedings of the 2nd Congress of surgeons of the southern Federal district with international participation; Rostov-on-Don, 24-28 June 2009. Rostov-on-Don; 2009. P. 27–28. (In Russ).
42. Timerbulatov VM, Sagitov RB, Timerbulatov ShV, Bogdasarov IuV. Miniinvasive techniques in urgent abdominal surgery: some organizational and clinical aspects. Endoscopic surgery. 2010;16(5):63–66. (In Russ).
43. Aliev SA, Aliev ES. Laparoscopic technologies in surgery of perforated gastroduodenal ulcers. Vestn Khir Im I I Grek. 2018;177(4): 101–105. (In Russ).
44. Beburishvili AG, Panin SI, Zyubina EN, et al. Minimally invasive techniques in the treatment of perforated cholecystitis. Endoscopic surgery. 2015;21(1):3–6. (In Russ).
45. Bombizo VA, Tseimakh EA, Ustinov DN, et al. Minimally invasive technologies in complex treatment of patients with acute fluid clusters in sterile pancreatonecrosis. Vestn Khir Im I I Grek. 2017;176(6):27–31. (In Russ).
46. Ermolov AS, Smoliar AN, Shliakhovskii IA, Khramenkov MG. 20 years emergency surgery of abdominal organs in Moscow. Khirurgiia (Mosk). 2014;5:7–16. (In Russ).
47. Zakharov DV, Ukhanov AP, Zhilin SA, et al. Endovideosurgical suture of perforated gastric and duodenal ulcers. Endoscopic surgery. 2018;24(3):17–20. (In Russ). doi: 10.17116/endoskop201824317.
48. Kolesnikov SA, Pahlevanyan GV, Kopylov AA, et al. Surgical tactics in injuries of the extrahepatic and major intrahepatic bile ducts as a result of minimally invasive cholecystectomies. Nauchnye vedomosti Belgorodskogo gosudarstvennogo universiteta. Meditsina, farmatsiya. 2015;(10):39–43. (In Russ).
49. Kulikovsky VF, Yarosh AL, Karpachev AA, et al. Minimally invasive management of biliary leakage after cholecystectomy. Khirurgiia (Mosk). 2018;(4):36–40. (In Russ). doi: 10.17116/hirurgia2018436-40.
50. Samsonov VT, Ermolov AS, Yartsev PA, et al. Laparoscopy for perforated gastroduodenal ulcers. Khirurgiia (Mosk). 2018;(10):23–26. (In Russ). doi: 10.17116/hirurgia201810123.
51. Fedorov IV, Chugunov AN, Slavin LE, Fedorov VI. Hasson laparoscopy complications. Povolzhskiy oncologicheskiy vestnik. 2019;10(1):26–30. (In Russ).
52. Sharp HT, Dodson MK, Draper ML, et al. Complications associated with optical-access laparoscopic throcars. Obstet Gynecol. 2002;99(4):553–555. doi: 10.1016/s0029-7844(02)01656-3.
