[Treatment of the diffuse septic peritonitis].

380 patients with the diffuse septic peritonitis were treated. All patients were divided in two groups depending on the treatment approach. The 1st group consisted of 245 patients, who were treated with the use of traditional approach, i.e., abdominal cavity sanation was performed with traditional antiseptics such as furacilin and sodium hypochlorite. The 2nd group, consisted of 135 patients. The abdominal cavity sanation was performed with water solution of sodium hypochlorite immobilized in gel. The postoperative complication rate decreased on 10%, the lethality rate was lower on 8,2% among the patients of the 2nd group. Authors decline the necessity of differential approach to the treatment choice, which should base on the severity factors.

[The application of immobilized forms of sodium hypochlorite in complex treatment of diffuse purulent peritonitis].

Complex examination and the following treatment of 380 patients with diffuse purulent peritonitis were analyzed. The patients were divided into 2 groups. The first group included 245 patients to whom the sanitization of the abdominal cavity used traditional antiseptics. The main group included 135 patients to whom the immobilized form of sodium hypochlorite in the carboxymethyl cellulose was introduced instead of aqueous solution. An original method of sanitization of the abdominal cavity allows 1.2-1.5 times decreased degree of endotoxicosis, 2-2.5 times improved the motor-evacuatory function of the intestine in different forms of treatment of peritonitis. In the main group of patients the number of postoperative complications was 10% less, lethality was 8.2% less.

[A new approach to treatment of the intraabdominal hypertension syndrome in patients with diffuse peritonitis].

Results of treatment of 49 patients with diffuse purulent peritonitis were analyzed. The patients were divided into two statistically similar groups. The control group of patients consisted of 27 patients treated using traditional methods. Patients of the main group (22) were treated by the same method, but the defect of the abdominal wall was closed using wide-meshed reticular polypropylene endoprosthesis with total size of the meshes not less than 70% of the general square surface. During every programmed sanation the prosthesis was cut longitudinally along the whole length and sutured so that the level of intraabdominal pressure was not more that 15 mm Hg. In the nearest postoperative period the main group patients had endotoxicosis 1.3 less, and the motor-evacuatory function of the intestine was 2.2 times higher which resulted in 1.3 times less postoperative lethality. In the long-term postoperative period excellent results of treatment became 13.3% more often, good results were 12.7% as compared with the control group.

[Decision on the method of surgical intervention for diffuse purulent peritonitis].

An analysis of complex examination and following treatment of 245 patients with diffuse purulent peritonitis has shown that the traditional (semi-closed) method of treatment should be used in patients with symptoms of abdominal sepsis. Programmed video-laparoscopies are indicated to patients with symptoms of abdominal sepsis with/without mono-organic insufficiency. Staged surgical sanations of the abdominal cavity are indicated to patients with severe abdominal sepsis with poly-organic insufficiency.

[Experimental-clinical grounds of the application of immobilized forms of sodium hypochlorite in treatment of diffuse peritonitis].

Experimental (200 experiments) and clinical (in 46 patients) investigations have shown that immobilized forms of sodium hypocloride in methylcellulose gel makes the lethality level 1.9 times lower and the formation of abdominal adhesions 1.8 times less in experimental peritonitis. In patients with diffuse peritonitis this form restores the propulsive ability of the intestinal tube 2 times quicker and makes lethality 2.7 times less.