POSSIBILITIES OF CONTROLLED LAPAROSTOMY IN THE TREATMENT OF WIDESPREAD PURULENT PERITONITIS COMPLICATED BY ABDOMINAL SEPSIS

Authors:
Alisher Okhunov, Dilshod Qorikhonov, Shokhista Bobokulova

Body of Abstract:
Background. Widespread purulent peritonitis is one of the leaders topping the list of causes of death in abdominal surgery, reaching up to 30%. However, in the context of the development of sepsis and multiple organ failure, mortality can reach 90%.
Methods. In the Department of Surgical Infection of the Multidisciplinary Clinic of the Tashkent Medical Academy, from 2021 to 2024, 58 patients with widespread purulent peritonitis were treated and examined. The causes of peritonitis were destructive appendicitis (8.6%), perforation of gastric and duodenal ulcers (6.9%), acute destructive cholecystitis (5.2%), infected forms of pancreatic necrosis (19%), abdominal injuries with damage to internal organs (22.4%), inflammatory diseases of the female genital organs (3.4%), malignant tumours of the intestine complicated by perforation of the intestinal wall (34.5%). General clinical, laboratory and instrumental research methods were used. Therapeutic measures included: laparostomy, total nasointestinal intubation, abdominal vacuum therapy, antibacterial and detoxification therapy.
Results. Out of 58 patients, recovery was in 43.1% of cases. Mortality was noted in 56.9% of cases (33 patients). Among the deceased patients, 78.8% did not undergo vacuum therapy due to the onset of death in the early stages after their admission to our clinic or after the application of a controlled laparostomy (up to 48 hours after surgery). The highest cause of mortality was progressive peritonitis, with the development of abdominal sepsis and multiple organ failure.
Conclusions. The use of controlled laparostomy in the treatment of widespread purulent peritonitis improves the results of surgical intervention, which is accompanied by a decrease in the frequency of postoperative complications and deaths.