Videolaparoscopic surgical interventions in emergency surgery

ScienceRise

Сергей Николаевич Завгородний¹  Михаил Анатольевич Кубрак¹  Владимир Валентинович Ганжий¹  Андрей Иванович Рылов¹  Михаил Богданович Данилюк¹  Галина Михайловна Грищенко²  Олег Дмитриевич Найденов² 

[1] Zaporozhye State Medical University26 Mayakovskogo ave., Zaporozhye, Ukraine, 69035;СІ "City Clinical Hospital of Emergency and ambulance с. Zaporozhye"80 Peremogy str., Zaporozhye, Ukraine, 69000;

关键词: videolaparoscopy;    appendicitis;    acute cholecystitis;    acute pancreatitis;    acute intestinal obstruction;   

DOI  :  10.15587/2313-8416.2016.65111

来源: DOAJ

【 摘 要 】

Aim: To improve the results of treatment of patients with emergency surgical pathology by the analysis of the use of videolaparoscopic surgical interventions.

Methods: in the period 2012–2014 year in MI “Zaporozhye municipal clinical hospital of emergency” in the first surgical department on the base of subdepartment “General surgery with care for patients” of Zaporozhye state medical university were carried out 791 videolaparoscopic surgical interventions.508 (64,2 %) women, 283 (35,8 %) men. The mean age of patients was 48±2,1.

The most videolaparoscopic operations were carried out at the acute appendicitis– 359 (45,5 %). Laparoscopic cholecystectomy at the acute cholecystitis was carried out in 157 patients (19,9 %). At the acute commissural intestinal obstruction were carried out 8 videolaparoscopic operations – (1 %). Videolaparoscopic drainage of abdominal cavity at the acute pancreatitis was carried out in 79 patients (10 %). At gynecological pathology were carried out 162 videolaparoscopic surgical interventions (20,6 %) and in 26 patients (3,1 %) was done diagnostic videolaparoscopy.

Result: At the acute appendicitis were carried out 359 (45,5 %) videolaparoscopic surgical interventions. There were no complications in postsurgical period. The mean bed-day was 6,8±0,7.

Videolaparoscopy at the acute cholecistitis was carried out in 157 patients (19,9 %). In 17 (10,8 %) was carried out conversion and surgical intervention was continued from laparotory access.

At the commissure intestinal obstruction were carried out 8 surgical interventions (1,0 %). All patients underwent surgery after the short-term pre-surgical preparation. Conversion was carried out in 2 patients (25 %). In 1 (12,5 %) was injured the loop of small intestine and in 1 (12,5 %) took place the total commissure disease in abdominal cavity.

Diagnostic laparoscopy was carried out in 26 patients (3,1 %), in two of them – at the close blunt trauma of the stomach.

Videolaparoscopic drainage of abdominal cavity at the acute pancreatitis was carried out in 79 patients (10 %). In 28 patients (35,4 %) along with drainage of abdominal cavity was carried out the laparoscopic cholecystectomy (concrements in gallbladder).

Conclusions: Videolaparoscopic surgical interventions in emergency surgery allow carry out the more qualitative diagnostics and significantly diminish the risk of postsurgical complications. The minimal surgical trauma allows activate patients in the early postsurgical period, shorten the terms of stay at hospital and improve the life quality.

Elaboration of indications and contraindications to videolaparoscopic surgical intervention in patients with emergency surgical pathology prevents the intrasurgical complications development

【 授权许可】

Unknown