[Repeated surgical operations for disseminated purulent peritonitis]

Results of surgical treatment were analyzed in 65 patients with disseminated purulent peritonitis (DPP). 34 patients undergoing re-laparotomy "on demand" formed the first group. 31 patients undergoing programmed re-laparotomy formed the second group. Lethality was higher in the first group (59% compared with 29% in the second group; p = 0.024). Risk of lethal outcome was higher in 2.5 times in patients from the first group (p = 0.030). Survival rate was evaluated using APACHE II scale, but the distinctions between two groups were not statistically significant (p = 0.178). According to APACHE II scale high indices were observed in deceased patients from both groups (26.1 +/- 8.9 in the first group, 19.7 +/- 5.9 in the second group; p = 0.009). Indications for programmed planned abdominal cavity sanation and laparostoma surgery in patients with DPP are described. Authors suggest that programmed sanations substantially improve the results of treatment in patients with DPP compared with re-laparotomy "on demand".