Modern methods for diagnosis and treatment of abdominal compartment syndrome
Journal Title: Хірургія України - Year 2018, Vol 0, Issue 1
Abstract
The aim — to study the effect of intraabdominal hypertension on the treatment outcome in patients with acute abdominal pathology and analyze modern methods for the treatment of abdominal compartment syndrome. Materials and methods. The work is based on the analysis of the treatment results in 33 patients urgently operated during the period from 2014 to 2016. All patients underwent preoperative and postoperative measurements of intra-abdominal pressure by indirect measurement of the bladder pressure using a closed system of Unometer Abdo-Pressure. In case when the pressure increased for more than 35 mm Hg, decompression laparotomy was performed. Results and discussion. In the postoperative period, an increase in intraabdominal pressure was diagnosed in 25 (75.8 %) patients. I degree of intraabdominal pressure was found in 7 (28 %) patients, II degree in 9 (36 %) patients, III degree in 5 (20 %) patients, IV degree of intraabdominal hypertension was noted in 4 (16 %) patients. At I — II degrees of intraabdominal pressure no lethal cases were observed. At grade III — IV, the disease ended in a lethal outcome in 5 (20 %) patients. The application of flat vacuum drains in the laparotomic wound allowed to stabilize the condition for two programmed abdominal sanitizations in 6 (24 %) patients, for three — in 3 (12 %) patients, which allowed to close the laparotomic wound. Conclusions. The incidence of intraperitoneal hypertension in patients operated on acute abdominal pathology was 25 (75.8 %) patients, and in 9 (36 %) patients, there was a need for decompression relaparotomy. The application of nasointestinal decompression, vacuum assisted laparotomy in the complex treatment of abdominal compartment syndrome allowed to stabilize the abdominal cavity, laparotomy wound for 7.0 ± 1.2 days and reduce mortality down to 20 %.
Authors and Affiliations
I. A. Kryvoruchko, V. V. Lesnoy, N. M. Goncharova, S. M. Teslenko, A. V. Sivozhelezov, M. O. Sykal, M. V. Suplichenko, A. G. Drozdova, A. S. Lesnaya
Keywords
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