Assuntos
Adenocarcinoma/patologia , Colectomia/métodos , Descompressão Cirúrgica/métodos , Colo Sigmoide/diagnóstico por imagem , Colo Sigmoide/patologia , Colo Sigmoide/cirurgia , Humanos , Obstrução Intestinal/etiologia , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores , Invasividade Neoplásica , Estadiamento de Neoplasias , Neoplasias do Colo Sigmoide/complicações , Neoplasias do Colo Sigmoide/patologia , Resultado do TratamentoRESUMO
AIM: To improve the results of surgical treatment of woundeds with combined thermomechanic injuries in local armed conflict. MATERIAL AND METHODS: It was analyzed treatment of 93 victims with thermomechanic injuries. In 29 (31.2%) aptients only Early Total Care protocol (ETC) was used up to 2001. These victims received complete surgical care. Since 2002 diffirentiated approach of multi-stage surgical treatment (Damage Control Surgery) has been applied. ETC tactics was used if systolic blood pressure was more than 90 mm Hg (30 woundeds, 32.2%). DCS protocol was preferred in case of blood pressure less than 90 mm Hg or multiple-organ failure (34 patients, 36.6%). RESULTS: Diffirentiated surgical approach decreases mortality rate from 13.8% to 7.8% (p=0.453) compared with group of conventional one-stage care.
