Scheduled Reoperations (Etappenlavage) for Diffuse Peritonitis

Teichmann, W.; Wittmann, D. H.; Andreone, Peter

doi:10.1001/archsurg.1986.01400020033002

Cited by 168 publications

(59 citation statements)

References 11 publications

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“…The most frequent causes of UARLs in patients undergoing colo-rectal surgery were found to be anastamosis leaks, intra-abdominal abescess and peritonitis, respectively. In a study evaluating relaparatomies, the colon was reported to be the major source of intra-abdominal infection leading to peritonitis (11). Anastomosis leaks, intra-abdominal abescess and peritonitis were mostly observed in patients undergoing colorectal surgery in our study.…”

Section: Discussionsupporting

confidence: 46%

“…In some studies, high mortality rates have been reported following UARLs performed due to peritonitis. On the other hand, there are studies reporting reduced mortality rates following planned re-laparatomies since they provided effective irrigation and drainage (11)(12)(13)(14). Consideration of UARLs has been suggested in the treatment of uncontrolled intra-abdominal infection and multisystem organ failure (15).…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of factors that affecting mortality in urgent redo-laparotomies

Uysal

Türel

Sezgın

2017

Medical Science and Discovery

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Section: Discussionsupporting

confidence: 46%

Section: Discussionmentioning

confidence: 99%

Evaluation of factors that affecting mortality in urgent redo-laparotomies

Uysal

Türel

Sezgın

2017

Medical Science and Discovery

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“…The indications for zip closure treatment remain debatable. The mortality varies between 7% and 67%, which likely results from varying methods of patient selection 10,16,20,31 . Van Goor et al 10 defined the indication for zip closure as diffuse suppurative peritonitis caused by colonic perforation or anastomotic dehiscence in which the abdominal cavity remains grossly contaminated after the initial laparotomy.…”

Section: Results Results Results Resultsmentioning

confidence: 99%

Temporary abdominal closure with zipper-mesh device for management of intra-abdominal sepsis

Utiyama

Pflug

Damous

et al. 2015

Rev. Col. Bras. Cir.

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OBJECTIVE: to present our experience with scheduled reoperations in 15 patients with intra-abdominal sepsis. METHODS: we have applied a more effective technique consisting of temporary abdominal closure with a nylon mesh sheet containing a zipper. We performed reoperations in the operating room under general anesthesia at an average interval of 84 hours. The revision consisted of debridement of necrotic material and vigorous lavage of the involved peritoneal area. The mean age of patients was 38.7 years (range, 15 to 72 years); 11 patients were male, and four were female. RESULTS: forty percent of infections were due to necrotizing pancreatitis. Sixty percent were due to perforation of the intestinal viscus secondary to inflammation, vascular occlusion or trauma. We performed a total of 48 reoperations, an average of 3.2 surgeries per patient. The mesh-zipper device was left in place for an average of 13 days. An intestinal ostomy was present adjacent to the zipper in four patients and did not present a problem for patient management. Mortality was 26.6%. No fistulas resulted from this technique. When intra-abdominal disease was under control, the mesh-zipper device was removed, and the fascia was closed in all patients. In three patients, the wound was closed primarily, and in 12 it was allowed to close by secondary intent. Two patients developed hernia; one was incisional and one was in the drain incision. CONCLUSION: the planned reoperation for manual lavage and debridement of the abdomen through a nylon mesh-zipper combination was rapid, simple, and well-tolerated. It permitted effective management of severe septic peritonitis, easy wound care and primary closure of the abdominal wall.

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“…Today, there is competition among various closed and open procedures for the treatment of difficult diffuse peritontitis [3][4][5], There have been no controlled randomized studies of the value of the treatment concepts practised today. Such an attempt is unlikely to be carried out in the future because of the unsatisfactory comparability of a heterogeneous collection of patients, despite classification attempts through indexes and scores, the complexity of the different therapy modalities and ethical reservations.…”

Section: Discussionmentioning

confidence: 99%

Scheduled Reoperations (Etappenlavage) for Diffuse Peritonitis

Teichman¹,

Herbig²

1996

Dig Surg

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The quality of surgical treatment is decisive for successful therapy of severe diffuse peritonitis. Modern concepts take into consideration the fact that surgical treatment of an intra-abdominal septic focus remains the most important element of therapy, but is not always achievable by a single operation. The concept of programmed relaparotomies (etappenlavage) has led to a significantly reduced mortality rate, especially in patients with postoperative peritonitis. It is a surgically demanding technique, requiring special experience in septic abdominal surgery. Optimum requirements for treatment of patients with diffuse peritonitis are therefore met in a specialized center for septic surgery.

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Scheduled Reoperations (Etappenlavage) for Diffuse Peritonitis

Cited by 168 publications

References 11 publications

Evaluation of factors that affecting mortality in urgent redo-laparotomies

Evaluation of factors that affecting mortality in urgent redo-laparotomies

Temporary abdominal closure with zipper-mesh device for management of intra-abdominal sepsis

Scheduled Reoperations (Etappenlavage) for Diffuse Peritonitis

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