Management of postoperative complications in patients with acute peritonitis

Abstract

Acute peritonitis remains one of the most severe and threatening abdominal cavity disease. An important component of the treatment of acute peritonitis is the ability to prognosis adequately the possibility of postoperative complications, which allows using appropriate preventive measures. For the case, numerous methods, based on the account of various parameters, are developed. Nevertheless, none of them is fully accepted, and useful. The purpose was to develop an informative scale for postoperative complications predicting. The retrospective analysis of the outcome of treatment of 169 patients with acute surgical pathology of abdominal organs complicated by various forms of peritonitis, 79 of whom developed postoperative complications results are presented. The dependence of occurrence and severity of complications on the nature of the underlying disease, clinical manifestations of peritonitis before surgery, anthropometric data research, laboratory methods, Mannheim peritonitis index parameters, comorbidity class, and age were studied, using the analysis of variance. A scale, according to which the prediction of complications is conducted in two stages, was developed. Before the surgery, we estimate the previous risk according to the nature of the underlying disease, clinical manifestations of peritonitis, comorbidity class. According to identified changes, the final estimation due to the nature of the underlying disease, Mannheim peritonitis index parameters, comorbidity class, stab neutrophil leukocytes number, use of programmed peritoneal cavity sanations is being made during the operation. These indicators provided a certain number of points. Due to these points, patients were referred to several groups: normal group (less than 18), increased (18-25), and medium (26-34) and high (more than 35) the risk of complications. The developed scale makes it possible to apply the necessary preventive measures at all stages of treatment, since preoperative preparation.