ENDOGENOUS INTOXICATION IN DIFFERENT METHODS OF SURGICAL INTERVENTIONS IN PATIENTS WITH PURULENT- INFLAMMATORY DISEASES OF THE ABDOMEN

The aim is to study endogenous intoxication in association with other indicators of homeokinesis in patients with purulent-inflammatory diseases of the abdominal cavity, who were operated by different surgical approaches.Material and methods. The results of surgical treatment of 107 patients with purulent-inflammatory diseases of the abdominal cavity are analyzed. The main studied group consisted of 55 (51.4%) patients after minimally invasive surgical approach - laparoscopy. The patients' age was 44.8±2.5 years (from 22 to 76 years). In the gender composition males prevailed (28 (50.9%). The control group included 52 (48.6%) patients after standard laparotomy. The age of patients ranged from 18 to 80 years. The average age was 45.6±2.5 years (p> 0.05). 27 (51.9%) (p> 0.05) of them were males. Both groups of patients were comparable according to the reasons of peritonitis development.Results. Comparative analysis showed that in the group of patients after minimally invasive operations, disorders of the indices of homeokinesis were less prolonged and less pronounced. This was primarily determined by the reduction of the phenomena of endogenous intoxication syndrome. A significant decrease in leukocyte index of intoxication, the level of molecules of average weight and lactoferrin was noted. The decrease in the level of the latter in the early stages after surgery in patients of the main group was less than the control by 9.7% (p <0.05).It turned out that in the early postoperative period after minimally invasive operations, a significant decrease in the severity of oxidative stress and phospholipase activity was recorded. So, after one day of the operation, the content of malondialdehyde in the blood plasma in the main group was less by 23.7%, after three -by 19.5%, after seven days - by 14.7% (p <0.05). At the same time, the antioxidant activity was quickly restored. A smaller increase in the activity of phospholipase A2 was found, which in the control group in the early postoperative period increased almost 1.5 times during a day (p <0.05). The advantages of laparoscopic operations were also expressed clinically, which was primarily determined by a significant decrease in hospital stay of patients in 2.8 beddays (p <0.05). A decrease in the number of wound complications by 17.4% (p <0.05) was noted.

перитонит, лапароскопия, эндогенная интоксикация, peritonitis, laparoscopy, endogenous intoxication