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[Surgical treatment of appendicular peritonitis in children]
Insights
This study shows aspiration drainage is effective for pediatric purulent peritonitis from appendicitis. The minimally invasive method reduced complications and relaparotomies, making it ideal for children.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
- Infectious Diseases
Context:
- Purulent peritonitis in children, often appendicular in origin, presents significant treatment challenges.
- Traditional approaches involve extensive surgical intervention, including irrigation and antibiotic administration.
- Minimally invasive techniques are sought to reduce morbidity in pediatric surgical patients.
Purpose:
- To evaluate the efficacy and safety of aspiration drainage for purulent peritonitis in children over a 10-year period.
- To assess the complication rates and need for re-operation using this conservative approach.
- To determine if aspiration drainage is a viable, less invasive alternative to standard treatments.
Summary:
- A 10-year study involving 980 children with purulent peritonitis of appendicular origin utilized aspiration drainage with a polymer tube.
- The method excluded intraoperative irrigation, postoperative lavage, and intraperitoneal antibiotics.
- Early detection and nonoperative management of complications were prioritized, resulting in a low relaparotomy rate (0.83%).
Impact:
- The aspiration drainage method demonstrates a high degree of safety and efficacy in treating pediatric purulent peritonitis.
- This approach aligns with pediatric surgery principles, offering a more conservative and sparing alternative.
- The findings support the widespread adoption of aspiration drainage in clinical practice for improved patient outcomes.
Abstract:
The article is based on the results of 10-year use of the method of aspiration drainage of the abdominal cavity in the treatment of 980 children with purulent peritonitis of appendicular origin. The authors used only a polymer tube to drain the cavity of the true pelvis and in principle did not resort to intraoperative irrigation of the abdominal cavity, postoperative lavage, and intraperitoneal injection of antibiotics. Postoperative complications were recognized in the early stages of development and were treated by nonoperative methods on the main. The number of relaparotomies was 0.83% of the total number of operations for appendectomy. The described method meets the principles of pediatric surgery most fully, is more sparing than the other methods, and the authors recommend it for wide introduction into practice.