González-Guaimare Ruth, Rivero Yeisson, Hernandez-Velasquez Adriana, Avila-Liendo Enrique, Rivas-Perez Miguel, Estrella-Gaibor Cesar, Antigua-Herrera Jackner, Gonzalez-Quinde Gabriel, Machado-Paled Debbye, Agudelo-Mendoza Silvia, Rodriguez-Rugel Tamara, Garcia-Cazorla Wilson
Department of Surgery, Universidad de Oriente, Núcleo Anzoátegui, Barcelona, VEN.
Department of Surgery, Universidad de Oriente, Núcleo Bolivar, Ciudad Bolivar, VEN.
Cureus. 2024 Aug 29;16(8):e68130. doi: 10.7759/cureus.68130. eCollection 2024 Aug.
Background Secondary peritonitis (SP) arises from direct contamination of the peritoneum by spillage from the gastrointestinal or urogenital tracts. Objective This research aimed to evaluate the clinical and epidemiological characteristics of patients with SP undergoing surgical management and to study potential factors associated with morbidity and mortality in a reference hospital in Eastern Venezuela. Methodology A retrospective cross-sectional study was conducted on patients aged 18 to 80 undergoing surgical treatment for SP at "Dr. Luis Razetti" University Hospital in Barcelona, Anzoátegui state, Venezuela, between January and December 2022. We calculated odds ratios to assess mortality risks based on the presence of postoperative complications. Results Analysis of 168 adult patients revealed a predominantly male population (n=110, 65.5%) with a mean age of 35.63 years (SD=14.34). Generalized peritonitis was observed in 126 cases (75%), primarily originating from the appendix (n=117, 69.6%). Postoperative complications occurred in 18 patients (10.7%); sepsis represented the most common associated complication (n=10, 43.5%). Patients with secondary peritonitis associated with acute appendicitis had a lower mortality rate (p=0.042). Additionally, laparotomy was associated with higher frequencies of complications (p=0.001) and mortality (p=0.025), while open appendectomy showed lower frequencies of complications (p=0.002) and mortality (p=0.035). Notably, patients experiencing postoperative complications had a significantly elevated risk of mortality (OR=98, 95% confidence interval = 21.74 - 441.69). Conclusion The most common source of SP was appendicular. Patients undergoing exploratory laparotomy for the management of SP had a higher frequency of complications and mortality, whereas those undergoing open appendectomy had lower rates of complications and mortality.
继发性腹膜炎（SP）源于胃肠道或泌尿生殖道溢出物对腹膜的直接污染。
本研究旨在评估接受手术治疗的SP患者的临床和流行病学特征，并研究委内瑞拉东部一家参考医院中与发病率和死亡率相关的潜在因素。
对2022年1月至12月期间在委内瑞拉安索阿特吉州巴塞罗那市“路易斯·拉泽蒂医生”大学医院接受SP手术治疗的18至80岁患者进行回顾性横断面研究。我们计算比值比以评估基于术后并发症存在情况的死亡风险。
对168例成年患者的分析显示，以男性为主（n = 110，65.5%），平均年龄为35.63岁（标准差 = 14.34）。126例（75%）观察到弥漫性腹膜炎，主要源于阑尾（n = 117，69.6%）。18例患者（10.7%）发生术后并发症；脓毒症是最常见的相关并发症（n = 10，43.5%）。与急性阑尾炎相关的继发性腹膜炎患者死亡率较低（p = 0.042）。此外，剖腹手术与更高的并发症发生率（p = 0.001）和死亡率（p = 0.025）相关，而开放性阑尾切除术的并发症发生率（p = 0.002）和死亡率（p = 0.035）较低。值得注意的是，发生术后并发症的患者死亡风险显著升高（比值比 = 98，95%置信区间 = 21.74 - 441.69）。
SP最常见的来源是阑尾。因SP接受探查性剖腹手术的患者并发症和死亡率较高，而接受开放性阑尾切除术的患者并发症和死亡率较低。
