The peculiarity of appendectomy of patients with high risk of cardiopulmonary insufficiency
Acute appendicitis (AA) ranks first in the frequency of emergence of urgent surgical diseases in hospitals in Ukraine. In recent years, laparoscopic appendectomy has become one of the “gold standards” of surgery. Of particular interest in this group of patients is a gasless and with small amount of gas laparoscopy, in which the endosurgical space in the abdominal cavity is created with the help of endolifts, in which the abdominal wall is raised mechanically, without creating a pneumoperitoneum. Objective — to determine the feasibility and effectiveness of the use of various techniques for laparoscopic appendectomy of patients with a high risk of cardiopulmonary insufficiency. All patients with АA were divided into 2 groups: Group 1 — 72 patients with АA diagnosis, with a high risk of cardiopulmonary failure, who underwent open appendectomy; Group 2 — 85 patients with АA diagnosis with a high risk of cardiopulmonary failure, who underwent laparoscopic appendectomy with pneumoperitoneum and using laparolifting method of patients. The laparolifting was performed with the help of the device developed by the clinic for laparolifting on Zaporozhchenko-Kolodii. When analyzing the results of treatment of patients with IІ group, it should be noted that laparoscopic appendectomy, especially with laparolifting, may be the operation of choice in the treatment of patients with acute appendicitis. This technique is absolutely safe, reliable and affordable in the implementation of most surgeons. So, laparoscopic appendectomy can be performed in virtually all patients with acute appendicitis with high risk of cardio-pulmonary insufficiency with the avoidance of postoperative complications.
2. Kahidze, L. A. (2010). Laparoskopicheskaya appendektomiya: pokazaniya, tehnika, neposredstvennye i otdalennye rezultaty [Laparoscopic appendectomy: indications, technique, immediate and long-term results]. (Dis. kand. med. nauk). Moskovskij gosudarstvennyj mediko-stomatologicheskij universitet, Moskva.
3. Kolodij, V. V. (2014). Effektivnost innovacionnoj liftingovoj tehnologii v laparoskopicheskoj hirurgii ostrogo holecistita u lic starshih vozrastnyh grupp [The effectiveness of innovative lifting technology in laparoscopic surgery of acute cholecystitis in the older age groups]. (Dis. kand. med. nauk). Odessa.
4. Mazitova, M. I. (2007). Optimizaciya endohirurgicheskih operacij v ginekologii s primeneniem izopnevmaticheskogo rezhima [Optimization of endosurgical operations in gynecology using the isopneumatic mode]. Endoskopicheskaya hirurgiya – Endoscopic surgery, 13 (5), 57–59. Retrieved from http://www.fesmu.ru/elib/Article.aspx?id=172003.
5. Elliott, S., Savill, P., & Eckersall, S. (1998). Cardiovascular changes during laparoscopic cholecystectomy: a study using transoesophageal Doppler monitoring. Eur. J. Anaesthesiol., 15 (1), 50–5. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/9522141.
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