Pathological changes in the abdominal cavity in acute appendicitis in the postcovid period according to laparoscopic appendectomy
EAES Academy. Mishchenko V. 07/05/22; 363103; P148
Prof. Vasyl Mishchenko
Contributions
Contributions
Abstract
Purpose:
determination of pathological changes in the abdominal cavity in patients with acute appendicitis in the postcoid period, detected during laparoscopic appendectomy. Materials and methods. Laparoscopic appendectomy was performed in 73 patients. The average age of the surveyed was 25.7 ± 0.5 years. The Alvarado scale was used for diagnosis. The presence of peritoneal symptoms was an unconditional indication for surgery. The Olympus OTV-SC endosurgical complex was used for laparoscopic appendectomy. Anesthesia - endotracheal anesthesia. The pressure of carbon dioxide in the abdominal cavity was maintained at the level of 10-12 mm. mercury column. The location of the troacars depended on the location of the appendix and was determined by the need to comply with the basic principle of triangulation. Appendectomy was performed using bipolar coagulation in standard modes of exposure, the stump of the appendix was processed with Reder's loops - a ligature method. The operation was completed with the installation of a safety drainage. Results. In 12.3% of patients, the time from the onset of the disease was 6 hours, in 35.6% - 6-12 hours, in 31.5% - 12-24 hours, in 20.5% - more than 24 hours. The preoperative follow-up period was 5.4 ± 1.2 hours. During the revision of the abdominal cavity, the visceral and parietal peritoneum in the right iliac region and the pelvic region, areas of the serous cover of the large and small intestines were with pronounced signs of edema, covered with a vesicular rash, in places in the conglomerates that were bleeding. There was no effusion in the abdominal cavity. The early and late postoperative periods proceeded without surgical complications. Disorders in the blood coagulation system, the immune system, positive definitions of IgG and IgM Covid-19 were revealed. All patients were discharged within 2 to 5 days after surgery. Conclusions. Appendectomy in patients who have undergone COVID-19 should be performed even before the development of complications from acute appendicitis. Laparoscopic appendectomy due to its advantages over open appendectomy, its safety should now become the gold standard for acute appendicitis surgery in patients with COVID-19.
determination of pathological changes in the abdominal cavity in patients with acute appendicitis in the postcoid period, detected during laparoscopic appendectomy. Materials and methods. Laparoscopic appendectomy was performed in 73 patients. The average age of the surveyed was 25.7 ± 0.5 years. The Alvarado scale was used for diagnosis. The presence of peritoneal symptoms was an unconditional indication for surgery. The Olympus OTV-SC endosurgical complex was used for laparoscopic appendectomy. Anesthesia - endotracheal anesthesia. The pressure of carbon dioxide in the abdominal cavity was maintained at the level of 10-12 mm. mercury column. The location of the troacars depended on the location of the appendix and was determined by the need to comply with the basic principle of triangulation. Appendectomy was performed using bipolar coagulation in standard modes of exposure, the stump of the appendix was processed with Reder's loops - a ligature method. The operation was completed with the installation of a safety drainage. Results. In 12.3% of patients, the time from the onset of the disease was 6 hours, in 35.6% - 6-12 hours, in 31.5% - 12-24 hours, in 20.5% - more than 24 hours. The preoperative follow-up period was 5.4 ± 1.2 hours. During the revision of the abdominal cavity, the visceral and parietal peritoneum in the right iliac region and the pelvic region, areas of the serous cover of the large and small intestines were with pronounced signs of edema, covered with a vesicular rash, in places in the conglomerates that were bleeding. There was no effusion in the abdominal cavity. The early and late postoperative periods proceeded without surgical complications. Disorders in the blood coagulation system, the immune system, positive definitions of IgG and IgM Covid-19 were revealed. All patients were discharged within 2 to 5 days after surgery. Conclusions. Appendectomy in patients who have undergone COVID-19 should be performed even before the development of complications from acute appendicitis. Laparoscopic appendectomy due to its advantages over open appendectomy, its safety should now become the gold standard for acute appendicitis surgery in patients with COVID-19.
Purpose:
determination of pathological changes in the abdominal cavity in patients with acute appendicitis in the postcoid period, detected during laparoscopic appendectomy. Materials and methods. Laparoscopic appendectomy was performed in 73 patients. The average age of the surveyed was 25.7 ± 0.5 years. The Alvarado scale was used for diagnosis. The presence of peritoneal symptoms was an unconditional indication for surgery. The Olympus OTV-SC endosurgical complex was used for laparoscopic appendectomy. Anesthesia - endotracheal anesthesia. The pressure of carbon dioxide in the abdominal cavity was maintained at the level of 10-12 mm. mercury column. The location of the troacars depended on the location of the appendix and was determined by the need to comply with the basic principle of triangulation. Appendectomy was performed using bipolar coagulation in standard modes of exposure, the stump of the appendix was processed with Reder's loops - a ligature method. The operation was completed with the installation of a safety drainage. Results. In 12.3% of patients, the time from the onset of the disease was 6 hours, in 35.6% - 6-12 hours, in 31.5% - 12-24 hours, in 20.5% - more than 24 hours. The preoperative follow-up period was 5.4 ± 1.2 hours. During the revision of the abdominal cavity, the visceral and parietal peritoneum in the right iliac region and the pelvic region, areas of the serous cover of the large and small intestines were with pronounced signs of edema, covered with a vesicular rash, in places in the conglomerates that were bleeding. There was no effusion in the abdominal cavity. The early and late postoperative periods proceeded without surgical complications. Disorders in the blood coagulation system, the immune system, positive definitions of IgG and IgM Covid-19 were revealed. All patients were discharged within 2 to 5 days after surgery. Conclusions. Appendectomy in patients who have undergone COVID-19 should be performed even before the development of complications from acute appendicitis. Laparoscopic appendectomy due to its advantages over open appendectomy, its safety should now become the gold standard for acute appendicitis surgery in patients with COVID-19.
determination of pathological changes in the abdominal cavity in patients with acute appendicitis in the postcoid period, detected during laparoscopic appendectomy. Materials and methods. Laparoscopic appendectomy was performed in 73 patients. The average age of the surveyed was 25.7 ± 0.5 years. The Alvarado scale was used for diagnosis. The presence of peritoneal symptoms was an unconditional indication for surgery. The Olympus OTV-SC endosurgical complex was used for laparoscopic appendectomy. Anesthesia - endotracheal anesthesia. The pressure of carbon dioxide in the abdominal cavity was maintained at the level of 10-12 mm. mercury column. The location of the troacars depended on the location of the appendix and was determined by the need to comply with the basic principle of triangulation. Appendectomy was performed using bipolar coagulation in standard modes of exposure, the stump of the appendix was processed with Reder's loops - a ligature method. The operation was completed with the installation of a safety drainage. Results. In 12.3% of patients, the time from the onset of the disease was 6 hours, in 35.6% - 6-12 hours, in 31.5% - 12-24 hours, in 20.5% - more than 24 hours. The preoperative follow-up period was 5.4 ± 1.2 hours. During the revision of the abdominal cavity, the visceral and parietal peritoneum in the right iliac region and the pelvic region, areas of the serous cover of the large and small intestines were with pronounced signs of edema, covered with a vesicular rash, in places in the conglomerates that were bleeding. There was no effusion in the abdominal cavity. The early and late postoperative periods proceeded without surgical complications. Disorders in the blood coagulation system, the immune system, positive definitions of IgG and IgM Covid-19 were revealed. All patients were discharged within 2 to 5 days after surgery. Conclusions. Appendectomy in patients who have undergone COVID-19 should be performed even before the development of complications from acute appendicitis. Laparoscopic appendectomy due to its advantages over open appendectomy, its safety should now become the gold standard for acute appendicitis surgery in patients with COVID-19.
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