Vlasov A P, Salakhov E K, Sheyranov N S, Markin O V, Shchapov V V
Ogarev National Research Mordovian State University, Saransk, Russia.
Mendeleevskaya Central District Hospital, Mendeleevsk, Russia.
Khirurgiia (Mosk). 2020(7):12-17. doi: 10.17116/hirurgia202007112.
To determine the value of membrane protective effect in intestine and liver cells for the effectiveness of minimally invasive surgery for acute peritonitis.
Patients with acute peritonitis undergoing laparoscopic (=60) and open (=50) surgery are analyzed. Functional characteristics of liver and bowel, disorders of homeostasis were evaluated in early postoperative period.
Reduced negative impact of surgical aggression on the state of liver and intestine is essential to improve treatment outcomes in patients with acute peritonitis undergoing minimally invasive surgery. Fast recovery of intestine inevitably results reduced release of endotoxins while restoration of liver function is associated with rapid elimination of these toxins. These processes prevent severe intoxication and facilitate accelerated recovery. Functional restoration of liver and bowel is associated with reduced oxidative stress during laparoscopic operations. It is also important because peritonitis causes activation of free-radical processes per se. Therefore, an additional source of oxidative phenomena is extremely undesirable in these cases.
Laparoscopic surgery for acute peritonitis minimizes surgical aggression and is associated with more favorable recovery of liver and bowel function. Undoubtedly, these findings should be considered to choose surgical approach in this severe category of patients.
