Complicated destructive appendicitis: finding the optimal treatment method
- Authors: Malkov IS1, Mamedov TA1, Shakirov MI2, Filippov VA1
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Affiliations:
- Kazan State Medical Academy — Branch of the Russian Medical Academy of Postgraduate Education
- City Clinical Hospital No. 7
- Issue: Vol 102, No 5 (2021)
- Pages: 751-756
- Section: Clinical experiences
- Submitted: 05.10.2021
- Accepted: 05.10.2021
- Published: 13.10.2021
- URL: https://kazanmedjournal.ru/kazanmedj/article/view/82472
- DOI: https://doi.org/10.17816/KMJ2021-751
- ID: 82472
Cite item
Abstract
Aim. To analyze the current practice for the surgical treatment of destructive acute appendicitis complicated by typhlitis and periappendicular abscess.
Methods. This study analyzed the treatment outcomes in 84 patients with acute destructive appendicitis aged 18 to 79 years who were treated in the Department of Surgery No. 2 of the City Clinical Hospital No. 7 of Kazan between 2016 and 2021 years. According to the method for completion of surgical intervention, patients were divided into 2 groups, similar in age, duration of the disease and morphological changes in the appendix. In the comparison group, 54 patients had the surgical intervention completed by gauze-glove drainage of the appendix bed. In 30 patients of the main group, the appendix stump and the adjacent intestinal wall was covered with a Tachocomb plate. Then the VAC system with the Vivano device and supplies from “Hartmann Group” (Germany) was connected. The statistical significance of the differences between the indicators was assessed by using the Student's t-test.
Results. The analysis of the surgical techniques used showed that in the main group, postoperative wound complications decreased by 3 times (23.3% of patients, p=0.04), intra-abdominal fluid collections decreased by 2 times (6.7% of patients, p=0.02), the hospital lengths of stay decreased by 1.8 times (p=0.02) compared with the comparison group.
Conclusion. The use of ligature appendectomy in combination with plastic closure of the appendix stump with a TachoComb and the technology of local vacuum-assisted laparostomy in patients with destructive appendicitis complicated by periappendicular abscess contributes to a 3-fold reduction in wound postoperative complications and reduces the hospital lengths of stay in this group of patients by 1.8 times.
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About the authors
I S Malkov
Kazan State Medical Academy — Branch of the Russian Medical Academy of Postgraduate Education
Email: vyacheslav_f@mail.ru
Russian Federation, Kazan, Russia
T A Mamedov
Kazan State Medical Academy — Branch of the Russian Medical Academy of Postgraduate Education
Email: vyacheslav_f@mail.ru
Russian Federation, Kazan, Russia
M I Shakirov
City Clinical Hospital No. 7
Email: vyacheslav_f@mail.ru
Russian Federation, Kazan, Russia
V A Filippov
Kazan State Medical Academy — Branch of the Russian Medical Academy of Postgraduate Education
Author for correspondence.
Email: vyacheslav_f@mail.ru
Russian Federation, Kazan, Russia
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