One thousand three hundred and ten patients with peritonitis have undergone surgery: local limited peritonitis was in 230 patients, local unlimited--in 342, general--in 738 patients. After surgery suppuration of the wound was seen in 92 (7.1%) patients, phlegmons of the abdominal wall--in 16 (1.3%), progressive peritonitis--in 40 (3.1%), abscesses of abdominal cavity--in 13 (1.0%), eventration--in 19 (1.5%), adhesive intestinal obstruction--in 17 (1.3%). Laparoscopy was used for diagnosis of intraabdominal complications in 47 patients. This allowed to avoid unjustified laparotomies in 20 patients. Application of laparoscopy is limited by degree of bacterial contamination of peritoneal exudates. Early adhesive intestinal obstruction in 7 patients was treated with endoscopic procedure. Sonography is effective in diagnosis of intraabdominal complications, detection of site of safe puncture before postoperative laparoscopy and drainage of abscesses.

Abdominal Abscess↗

PubMed2002

[Fibrin-collagen substance as a vehicle for local application of antibacterial agents].

Inhibitory activity of fibrin-collagen substance (FCS) impregnated by various antibacterial agents against various microorganisms was investigated. It was demonstrated that antibacterials bind well with FCS, providing its sufficient antibacterial activity. Determination of growth-inhibition zones showed that antibacterial agents diffuse into medium well and demonstrated the same activity as discs with antibiotics. For clinical practice it is recommended to use for impregnation the following drugs: gentamycin, meropenem, cefriaxone and ciprofloxacin.

Administration, Topical↗

PubMed2001

[Use of fibrin-collagen plates in abdominal surgery].

The article presents results of experimental substantiation and clinical use of fibrin-collagen plates Tachocomb. They were used in clinical practice in 28 patients with different bleedings under conditions of open and little invasive surgery. The preparation not only increases the mechanical strength of the surgical suture, but also has a stimulating effect on reparative processes. The author proposes to use Tachocomb for strengthening the sutures and anastomoses in peritonitis, intestinal obstruction and interventions in the area of the tissues altered due to infiltration.

Abdomen↗

PubMed2001

[Can perforated ulcer be not sutured?].

Experiments in 5 pigs and 18 mongrel dogs have shown the possibility to close perforating ulcers with plates of biopolymer "Tachocomb". The method is proposed as an alternative to suturing perforations in the zone of pylorus in order to prevent stenosis of the pyloric part of the stomach. The experimental data obtained have confirmed good adhesive and stimulating properties of the fibrin-collagen substance. Successful results of using the method were demonstrated in 2 patients with perforating ulcers.

Adult↗

PubMed2001

[Technical aspects of the use of TakhoKomb in surgery of abdominal organs].

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Abdomen↗

PubMed2001

[Diagnosis and treatment of acute adhesive small intestine obstruction].

Experience of treatment of 162 patients with acute adhesive intestinal obstruction (AAIO) is described. These patients had most often (23.3%) appendectomy in anamnesis. Conservative treatment was effective in 23 (14.2%) patients only. Surgical treatment was performed in 139 (85.8%) patients including traditional open operation in 79 (56.8%) patients, laparoscopic and laparoscopy-assisted in 60 (43.2%). Advanced adhesive process with formation of single intestinal conglomerate, neglected forms of AAIO with paralytic ileus were indications to open operations; lethality in these operations was 17.7%. Laparoscopic operation was indicated in AAIO due to isolated commissure as well as in early adhesive obstruction; lethality was 1.7%. If diagnostic laparoscopy showed that AAIO is caused by intestinal deformation in small intestinal conglomerate or intestinal resection is required, laparoscopy-assisted operations were performed.

Acute Disease↗

PubMed2001

[Results and prospects of treatment of general forms of peritonitis].

956 patients with general peritonitis were operated: 596 patients--for diffuse peritonitis, 360--for general peritonitis. The causes of peritonitis were: perforating gastroduodenal ulcers (454), acute destructive appendicitis (190), acute destructive cholecystitis (82), perforation of small intestine and colon (96), postoperative peritonitis (80), other diseases (54). In low degree of bacterial contamination of abdominal cavity (not more Ig 5 CFU/g) operations were completed without abdominal drainage, laparoscopic variant of the operation being optimal. In postoperative period, out of 691 patients with low degree of bacterial contamination wound infection was in 7.9%, intraabdominal infection--in 2.5%, polyorganic insufficiency--in 1.0%; lethality was 5.9%. In high degree of bacterial contamination (more Ig 5 CFU/g) and massive unremovable fibrinous patch on the peritoneum the programmed revisions and sanations of abdominal cavity were performed, sometimes--control laparoscopic revisions. In postoperative period of 256 patients with high degree of bacterial contamination wound infection arose in 6.0%, intraabdominal infection--in 4.2%, polyorganic insufficiency [symbol: see text] in 42.6%; lethality was 18.1%.

Adult↗

PubMed2001

[Intraabdominal cholerrhea after cholecystectomy].

Cholecystectomy (CE) was performed in 2303 patients with cholelithiasis and its complications. Cholerrhea (CR) after operation was in 31 (1.34%) patients: after laparoscopic CE (1425 patients)--in 18 (1.26%), after open CE (878 patients)--in 13 (1.48%). Source of CR was not found in 21 patients, CR from gall bladder bed was revealed in 7, from cystic duct stump--in 2, from hepaticojejunoanastomosis--in 1 patient. Ultrasonic examination, endoscopic retrograde pancreatocholangiography, laparoscopy were used for diagnosis of this complication. CR stopped spontaneously in 19, after endoscopic papillosphincterotomy--in 4 patients. Spread of bile in abdominal cavity was revealed in 6 patients, 4 of them underwent laparoscopic operations, 2--open operations. Infrahepatic encapsulated bile clumps were in 2 patients, they underwent ultrasonic-assisted drainage.

Cholecystectomy↗

PubMed2001

[Complications of laparascopic cholecystectomy].

1389 laparoscopic operations were fulfilled for chronic and acute cholecystitis. In 41 patients (3%) it was necessary to pass on to laparotomy. Injury of hepaticocholedochus was made in 6 patients (0.5%), bleedings appeared in 9 (0.7%), bile leakage at the postoperative period--in 9 (0.5%). Subhepatic abscess was formed in 2 patients. Wound complication sat at the postoperative period developed in 33 patients (2.5%), pulmonary complications--in 7 patients. One patients died of myocardial infarction. The most frequent causes of intraoperative injuries of the vascular and duct structures of the hepatoduodenal ligament and the bile bladder bed were found to be cicatricial and inflammatory alterations of the areas mentioned and non-typical variants of the anatomical situs of the vessels and bile ducts. The detailed examination of the patients at the preoperative period, knowledge of the anatomical variants of the disposition of bile and vascular structures in the operation zone allow to prevent their intraoperative injury.

Cholecystectomy, Laparoscopic↗

PubMed2000

[Mode of surgery completion in peritonitis].

1310 patients with various forms of peritonitis were operated during 1989-1998. The tactics of the treatment was determined depending on bacterial contamination of the abdominal cavity. In abscesses of the abdominal cavity with massive bacterial contamination (6-7 CFU/g) drainage procedure was used. Mortality rate made up 4.8%. In local extended and diffuse peritonitis with a slight bacterial contamination of the abdominal cavity (3-5 CFU/g) and in absence of fibrinous deposition fixed on peritoneum, the drainage of the abdominal cavity was not used, and laparoscopy was performed in postoperative period for the control of the course of infectious process. Mortality rate was 0.6%. In extended peritonitis with massive bacterial contamination (6-8 CFU/g) the method of repeated explorations and sanitations of the abdominal cavity was used, mortality rate being 17.8%. The overall lethality made up 7.8%. Postoperative wound infection occurred in 6.7%, intraabdominal infection as abscesses or progressing peritonitis--in 2.1% of cases.

Humans↗

PubMed1999

[Technical aspects of nasointestinal intubation].

According to the authors' opinion nasointestinal intubation have some advantages over "open" methods of decompression of the small bowel in paralytic intestinal obstruction resulted from peritonitis and mechanical obstruction of the small bowel. The authors' experience with more than 500 their own cases indicates, that application of nasointestinal intubation is not only necessary, but safe as well if keeping strictly to the established technique. Technical aspects of the method, possible errors which could occur during the performance of nasointestinal intubation and introduction of the probe are described. Complications which made up 2.6% are analysed.

Gastrointestinal Diseases↗

PubMed1999

[Pilot experience of pyloroduodenal area hole closure by preparation "Takho_Comb" without preliminary suture].

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Animals↗

PubMed1992

[Ciprofloxacin and other antimicrobial drugs in the treatment of disseminated peritonitis].

Forty two patients with general peritonitis were treated with ciprofloxacin and combinations of various antimicrobial drugs. Ciprofloxacin had the highest effect on aerobic and anaerobic microbes in the peritoneal cavity which defined the favourable clinical results in all the patients. Moreover, there were observed no disorders in the composition of the normal intestinal microflora which in the end promoted a decrease in the number of the patients with suppuration of the surgical wound.

Adolescent↗

PubMed1990

[Treatment of peritonitis of appendicular etiology].

The authors had 475 patients with appendicular peritonitis under observation. All of them underwent emergency operation and were given antibacterial therapy with metronidazole and agents of the aminoglycoside series. Among 223 patients, the operation on whom was completed by traditional drainage of the abdominal cavity and complete closure of the operative wound, 148 patients developed postoperative complications. Five patients died. In 252 patients, primarily delayed sutures were applied to the wound and drainage of the abdominal cavity was limited. The abdominal cavity was inspected repeatedly in 24 patients with generalized peritonitis and clinical signs of anaerobic nonclostridial infection. Postoperative complications occurred in 87 patients and were limited to suppuration of the wound. One patient died.

Adolescent↗