ACTA FAC. MED. NAISS. 2005; 22(4):191-194

   Original article

Zorica Stamenković¹, Milan Radojković¹, Miroslav Stojiljković¹, Danijela Radojković², Danilo Stojiljković¹, Ljiljana Jeremić¹, Milica Nestorović<sup>1

1</sup> Surgical Clinic of the Clinical Center of Niš
² Endocrinology, Diabetes and Metabolism Illnesses Clinic of the Clinical Center of Niš

The aim of the study was to use a comparative analysis to evaluate the efficiency of therapy and the importance of different methods of surgical treatment of the most severe cases of secondary peritonitis (the classic "on demand" approach, continuous postoperative lavage-CPL and STAR-method) and to show our experience and results by applying new, more "aggressive" therapeutic approaches. A cohort of 1485 patients with SP who were surgically treated at the Surgical Clinic of the Clinical Center of Ni{ within the period between June 1st, 1994 to June 1st, 2003 were analyzed retrospectively and classified into three groups according to severity of secondary peritonitis using MPI scoring system. These groups were further classified into subgroups of patients who underwent different methods of surgical treatment (the common "on-demand" approach, CPL-Continuous postoperative lavage and STAR). The efficiency of the therapy of the applied methods was evaluated by analyzing and comparing clinical parameters (duration of hospitalization, incidence of local and systemic complications, number of relaparotomies, mortality rate) using the test. Comparing the results obtained by applying the aforementioned testing methods of surgical treatment, better therapeutic efficiency of the new, more "aggressive" approach has been shown (according to all parameters), which, with the lack of more efficient ones, today does represent the most powerful weapon of the surgical treatment of severe intra-abdominal infections.

Key words: severe secondary peritonitis, surgical treatment