Statsenko N. Laparostomy in operative treatment of the postoperative peritonitis

The scientific work is dedicated to the actual problem – the improvement of the surgical treatment of the postoperative peritonitis. The thesis consists of two parts: clinical and experimental. The clinical section is based on 101 clinical cases of the patients with the postoperative peritonitis. The results of surgical treatment of these patients were investigated and analyzed. Among them were 50 patients treated by the method of laparostomy including the modified methodic and 51 patients after the programmed relaparotomies. The received results show the reliable decrease in the number of complications and deaths after usage of the method of laparostomy in comparison with the method of programmed relaparostomy, р<0,05 and р<0,05 relatively. The level of the bactericidal activity of the serum against E.coli and S.aureus, microbe colonization of the abdominal cavity and the dynamics of the bacteremia were investigated. The received data shows the absence of the significant differences in the species composition of the micro flora of peritoneal exudates taken from the patients of the under study groups and predictive value of level and dynamics of bactericidal activity of serum in development of postoperative complications and treatment outcomes in patients with the postoperative peritonitis. The life quality of the patients with the postoperative peritonitis was studied in long term period. The comparison between groups of patients after the laparostomy, programmed relaparotomy and healthy people was performed as well. The results showed the more severe asthenia in the group of the patients after the programmed relaparotomy. The experimental part is dedicated to the research of the local blood flow in the bowel wall and dynamics of changes of the partial pressure of oxygen in blood in the acute experiments on the 30 rabbits. The received results show the significant advantage of the laparostomy methodic against the programmed relaparotomy under all studied parameters.