Regional lymphatic stimulation and ozonized solutions in the prevention of complications after appendectomy with an atypical location of the appendix (pilot study)

Abstract

Acute appendicitis still predominates among surgical diseases. Despite the improvement in the technique of surgical intervention and treatment, the frequency of its complications ranges from 2 to 14%, which requires improvement of measures to prevent complications during operations and in the postoperative period. The aim of our work was to evaluate the effectiveness of the use of regional lymphatic stimulation and ozonized solutions in the prevention of complications after appendectomy with an atypical location of the appendix. Material and methods. The analysis included 45 patients with an atypical location of the appendix. Retrocecal was found in 25, retroperitoneal – in 12, and mesoceacal – in 8 patients. To assess the preventive measures used, 2 groups were identified. The comparison group consisted of 21 patients who received traditional treatment after surgery (to prevent complications antibiotics – ampicillin 1.0 g 4 times or gentamicin 80 mg 2 times a day for 4–5 days), pain relievers and infusion therapy. The main group included 24 patients who received regional lymphatic stimulation of the transitional fold of the peritoneum of the ileocecal region and the mesentery of the ileum, irrigation of the bed of the removed process and the surgical wound before suturing with ozonized sodium chloride solution with an ozone concentration of 8–10 μg/ml. In the diagnosis of appendicitis, clinical, laboratory (leukocyte count, leukocyte intoxication index) signs of the disease, and ultrasound were used. Results. In the comparison group, after surgery, suppuration appeared in 4 patients, wound infiltration was in 3 cases, early adhesive intestinal obstruction emerged once. Relaparatomy was performed with a favorable outcome. In the main group, one case of suppuration and infiltration of a postoperative wound was observed. By the time of discharge, all complications have been cured. There were no lethal outcomes. The hospital stay in the comparison group was 8.1 ± 0.37 bed-days, in the main group – 6.6 ± 0.12. Conclusions. The use of regional lymphatic stimulation can reduce the incidence of complications and shorten the length of hospital stay.