INTRODUCTION: Bacterial peritonitis is a severe medical condition associated with a natural mortality rate of 80-100%. Progress in surgical techniques, new developments in intensive care medicine and antibiotic therapy reduced this rate significantly. Aim of this study was to evaluate sepsis parameter in perforated appendicitis and different postoperative management. METHODS: In 50 consecutive patients with diffuse bacterial peritonitis and perforated appendicitis, laparotomy was performed. Subsequently, 25 patients were treated with adjuvant, continuous peritoneal lavage (CPL) using standard peritoneal dialysis (CAPD)-solution. The remaining 25 patients were peritoneally drained without postoperative irrigation (Non-CPL). In all patients endotoxin, tumor necrosis factor-alpha (TNF-alpha), interleukin (IL-6), C-reactive protein (CRP) and myeloid-related protein (MRP-8, MRP-14 and Heterocomplex) were determined. RESULTS: No difference in clinical outcome between CPL and Non-CPL could be established. An uncomplicated clinical outcome was associated with lower levels of inflammation markers. Furthermore, clinical data revealed that mortality depended on co-morbidity, and patient's age. SUMMARY: In perforated appendicitis a faster decrease of mediator release could not be achieved with either method. In addition, no difference could be established for the clinical parameters like hospitalization, duration of intensive care and morbidity.
INTRODUCTION: Bacterial peritonitis is a severe medical condition associated with a natural mortality rate of 80-100%. Progress in surgical techniques, new developments in intensive care medicine and antibiotic therapy reduced this rate significantly. Aim of this study was to evaluate sepsis parameter in perforated appendicitis and different postoperative management. METHODS: In 50 consecutive patients with diffuse bacterial peritonitis and perforated appendicitis, laparotomy was performed. Subsequently, 25 patients were treated with adjuvant, continuous peritoneal lavage (CPL) using standard peritoneal dialysis (CAPD)-solution. The remaining 25 patients were peritoneally drained without postoperative irrigation (Non-CPL). In all patients endotoxin, tumor necrosis factor-alpha (TNF-alpha), interleukin (IL-6), C-reactive protein (CRP) and myeloid-related protein (MRP-8, MRP-14 and Heterocomplex) were determined. RESULTS: No difference in clinical outcome between CPL and Non-CPL could be established. An uncomplicated clinical outcome was associated with lower levels of inflammation markers. Furthermore, clinical data revealed that mortality depended on co-morbidity, and patient's age. SUMMARY: In perforated appendicitis a faster decrease of mediator release could not be achieved with either method. In addition, no difference could be established for the clinical parameters like hospitalization, duration of intensive care and morbidity.
Authors: Louis J X Giesen; Anne Loes van den Boom; Charles C van Rossem; P T den Hoed; Bas P L Wijnhoven Journal: Dig Surg Date: 2016-09-16 Impact factor: 2.588
Authors: Andrew W Kirkpatrick; Federico Coccolini; Luca Ansaloni; Derek J Roberts; Matti Tolonen; Jessica L McKee; Ari Leppaniemi; Peter Faris; Christopher J Doig; Fausto Catena; Timothy Fabian; Craig N Jenne; Osvaldo Chiara; Paul Kubes; Braden Manns; Yoram Kluger; Gustavo P Fraga; Bruno M Pereira; Jose J Diaz; Michael Sugrue; Ernest E Moore; Jianan Ren; Chad G Ball; Raul Coimbra; Zsolt J Balogh; Fikri M Abu-Zidan; Elijah Dixon; Walter Biffl; Anthony MacLean; Ian Ball; John Drover; Paul B McBeth; Juan G Posadas-Calleja; Neil G Parry; Salomone Di Saverio; Carlos A Ordonez; Jimmy Xiao; Massimo Sartelli Journal: World J Emerg Surg Date: 2018-06-22 Impact factor: 5.469
Authors: Zhengwen Xiao; Crystal Wilson; Helen Lee Robertson; Derek J Roberts; Chad G Ball; Craig N Jenne; Andrew W Kirkpatrick Journal: Crit Care Date: 2015-10-27 Impact factor: 9.097