ABSTRACT
Results of 276 laparoscopic operations performed for diagnostic and therapeutic purposes in the early postoperative period in 198 patients are analyzed. All the patients had been previously operated on the organs of the abdominal cavity and retroperitoneal space: in 131 patients the investigations were performed with a diagnostic purpose; in 67 patients a laparoscopic method was used for treatment of complications of the early postoperative period. This problem can be solved by using the methods allowing diagnosing the complication as early as possible, before the development of irreversible alterations, and allowing to choose the most rational methods of treatment.
Subject(s)
Laparoscopy , Postoperative Complications/diagnosis , Postoperative Complications/surgery , Abdominal Abscess/diagnosis , Abdominal Abscess/surgery , Aged , Aged, 80 and over , Appendectomy , Appendicitis/diagnosis , Appendicitis/surgery , Cholecystectomy, Laparoscopic , Diagnosis, Differential , Female , Gastrointestinal Hemorrhage/diagnosis , Gastrointestinal Hemorrhage/surgery , Humans , Intestinal Obstruction/diagnosis , Intestinal Obstruction/surgery , Laparotomy , Peritoneal Cavity , Peritonitis/diagnosis , Peritonitis/surgery , Postoperative Period , Reoperation , Time FactorsABSTRACT
Results of treatment of 334 patients who had intra-abdominal complications in the early postoperative period were analyzed. Among them there were 160 patients (47.9%) aged 60 years and older. Reoperations for different complications were performed on 311 patients including 141 patients from the older age group that made up 45.3%. The primary operations were performed on 131 elderly and senile patients for emergency and urgent indications. Planned operations on organs of the abdominal cavity were performed on 29 (18.1%) patients. Our experiences include 114 laparoscopies in 92 elderly and senile patients with the aim to diagnose and treat early postoperative intra-abdominal complications. A suspected intra-abdominal complication or high risk of its appearance was considered as an indication for the investigation. The laparoscopic method for diagnosing and treatment of this category of patients is thought to be a perspective direction for the improvement of results of treatment of a pathology of the early postoperative period.
Subject(s)
Abdominal Abscess/etiology , Ileus/etiology , Peritonitis/etiology , Postoperative Complications , Postoperative Hemorrhage/epidemiology , Abdomen , Abdominal Abscess/epidemiology , Aged , Female , Humans , Ileus/epidemiology , Laparoscopy , Male , Middle Aged , Peritonitis/epidemiology , Postoperative Complications/mortality , Survival RateABSTRACT
In order to generalize the indications for drainage of the abdominal cavity the authors have systematized and subdivided them into one-type groups depending on the aims, (medical, prophylactic) and tasks, which on their opinion can allow the surgeons to better realize the reasons of using this method of treatment and to critically assess it. An analysis of clinical material was made in order to find out the frequency and localization of intraabdominal abscesses and to assess the measures taken for their prevention. It was found that in spite of the abdominal cavity drainage after 1568 operations on emergency indications, abscesses developed in 43 patients. An analysis of the investigation has shown that the causes, frequency and localization of postoperative abscesses are not predictable, prophylactic measures have low efficiency due to using passive glove-tube drainage and to too frequent using this not safe method without special need.
