ABSTRACT
AIM: To assess an effectiveness of minimally invasive and laparoscopic technologies in treatment of inflammatory complications of colic diverticular disease. MATERIAL AND METHODS: The study included 150 patients who were divided into control and main groups. Survey included ultrasound, X-ray examination and abdominal computerized tomography. In the main group standardized treatment algorithm including minimally invasive and laparoscopic technologies was used. RESULTS: In the main group 79 patients underwent conservative treatment, minimally invasive (ultrasound-assisted percutaneous drainage of abscesses) and laparoscopic surgery that was successful in 78 (98.7%) patients. CONCLUSION: Standardized algorithm reduces time of treatment, incidence of postoperative complications, mortality and the risk of recurrent inflammatory complications of colic diverticular disease. Also postoperative quality of life was improved.
Subject(s)
Abdominal Abscess , Colectomy , Colon , Diverticulitis, Colonic , Laparoscopy , Minimally Invasive Surgical Procedures , Postoperative Complications , Quality of Life , Abdominal Abscess/diagnosis , Abdominal Abscess/etiology , Abdominal Abscess/surgery , Aged , Colectomy/adverse effects , Colectomy/methods , Colon/diagnostic imaging , Colon/surgery , Colonography, Computed Tomographic/methods , Diverticulitis, Colonic/diagnosis , Diverticulitis, Colonic/epidemiology , Diverticulitis, Colonic/physiopathology , Diverticulitis, Colonic/surgery , Drainage/methods , Emergency Service, Hospital/statistics & numerical data , Female , Humans , Laparoscopy/adverse effects , Laparoscopy/methods , Male , Middle Aged , Minimally Invasive Surgical Procedures/adverse effects , Minimally Invasive Surgical Procedures/methods , Postoperative Complications/diagnosis , Postoperative Complications/mortality , Postoperative Complications/psychology , Postoperative Complications/surgery , Recurrence , Retrospective Studies , Treatment OutcomeABSTRACT
AIM: To review one of actual problems of emergency surgery - diagnosis and treatment of patients with non-occlusive mesenteric circulatory disorders. MATERIAL AND METHODS: The article presents the clinical observations showing the ambiguity of clinical picture, features and challenges of diagnosis, treatment of disease and opportunities for positive outcomes. Diagnostic methods are x-ray, abdominal ultrasonography according to which acute abdominal ischemia may be assumed. However, in all unclear cases diagnostic videolaparoscopy is mandatory to determine further tactics. Unfortunately diagnostic videolaparoscopy is not always interpreted comprehensively and not a definitive method of diagnosis. Wide surgical access is usually necessary for non-occlusal acute violation of mesenteric circulation and volume of surgery varies from segmental to subtotal intestinal and colic resection with obligatory enteral intubation and decompression. Thus, complex pre- and postoperative treatment is required.
