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. 2009; 15(1): 52-57 | |||
Ağır sekonder peritonitli hastalarda laparostomiDogan Gonullu1, Ferda Nihat Köksoy1, Okan Demiray1, Sibel Gurdal Ozkan2, Tayfun Yucel3, Osman Yucel11Taksim Eğitim Ve Araştırma Hastanesi, Genel Cerrahi Kliniği, İstanbul2Namık Kemal Üniversitesi Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Tekirdağ 3Sakarya Üniversitesi Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Sakarya AMAÇ: Bu çalışmada, sekonder peritonitli hastaların tedavisinde, Bogota bag ile geçici karın kapatmanın etkinliği ve sağ kalımdaki risk faktörleri değerlendirildi. Laparostomy in patients with severe secondary peritonitisDogan Gonullu1, Ferda Nihat Köksoy1, Okan Demiray1, Sibel Gurdal Ozkan2, Tayfun Yucel3, Osman Yucel11Department Of General Surgery, Taksim Training And Research Hospital, Istanbul2Department Of General Surgery, Namık Kemal University, Faculty Of Medicine, Tekirdağ 3Department Of General Surgery, Sakarya University Faculty Of Medicine, Sakarya, Turkey BACKGROUND: The aim of this study was to evaluate the effectiveness of laparostomy with the Bogota bag for the management of patients with severe secondary peritonitis and the risk factors for survival. METHODS: Thirty-seven patients (22 males, 15 females; mean age 63.5; range 44 to 83 years) with secondary peritonitis were treated by laparostomy and temporary closure with Bogota bag. APACHE II scores and Mannheim Peritonitis Index (MPI) were used to calculate the disease severity. The outcomes and effectiveness of APACHE II and MPI values were analyzed retrospectively. RESULTS: The mortality rate was 43.2%. Significant differences were noted between survivors and non-survivors according to initial APACHE II and MPI scores and the number of operations. The non-survivors had higher APACHE II (r=0.81, p=0.001) and MPI (r=0.39, p=0.02) scores. The patients who survived were re-operated 1.6 times and those who died were re-operated 4.7 times. In five patients, laparostomy was closed primarily, while in the others, the wound was left open to heal secondarily. CONCLUSION: Patients with higher APACHE II and MPI scores and number of operations had higher rates of mortality due to their major risk factors. Temporary abdominal closure using the Bogota bag in patients with secondary peritonitis is an inexpensive-simple method, permitting evaluation of underlying viscera and recognition of infection. Keywords: APACHE II, Bogota bag; intraabdominal morbidity; Mannheim Peritonitis Index; mortality; secondary peritonitis; temporary abdominal closure.Dogan Gonullu, Ferda Nihat Köksoy, Okan Demiray, Sibel Gurdal Ozkan, Tayfun Yucel, Osman Yucel. Laparostomy in patients with severe secondary peritonitis. . 2009; 15(1): 52-57 Sorumlu Yazar: Dogan Gonullu, Türkiye |
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