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[Programmed lavage as a basic principle in therapy of diffuse peritonitis]

U Adam1, D Ledwon, U T Hopt

  • 1Klinik und Poliklinik für Allgemeine- und Transplantationschirurgie, Universität Rostock.

Langenbecks Archiv Fur Chirurgie
|January 1, 1997
PubMed
Summary
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Programmed lavage effectively treats severe diffuse peritonitis, though outcomes depend on organ failure severity. This intensive therapy involves multiple relaparotomies, with complications including fistulas and bleeding.

Area of Science:

  • Surgical critical care
  • Gastroenterology
  • Abdominal surgery

Context:

  • Severe diffuse peritonitis presents significant therapeutic challenges.
  • Programmed lavage is an established treatment modality for this condition.
  • Patient outcomes are influenced by the extent of organ system failure.

Purpose:

  • To evaluate the efficacy and outcomes of programmed lavage in patients with severe diffuse peritonitis.
  • To analyze the lethality rates and complication profiles associated with this treatment.

Summary:

  • Thirty patients with severe diffuse peritonitis received programmed lavage between January 1995 and February 1997.
  • The overall lethality rate was 30% (11/30).
  • Patients with three or four organ system failures at initial laparotomy had a 50% lethality rate, with an average of 9.2 programmed relaparotomies per patient. Early complications included small bowel fistulas, bleeding, and laparostomy-related issues.

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Impact:

  • Programmed lavage is a viable, albeit intensive, treatment for severe diffuse peritonitis.
  • Identifying patients with multi-organ failure is crucial for risk stratification and management.
  • Understanding complication rates informs surgical planning and patient care protocols.