Delayed Small-Bowel Anastomosis in Patients With Postoperative Peritonitis

NCT03690687 | Unknown

• 1 other identifier: Postoperative peritonitis
• Study Type: observational
• Target: 114
• Locations: 0 countries
• Sites: N/A

Brief Summary

Surgical management results for 114 patients with postoperative peritonitis due to small-bowel perforations, necrosis, and anastomotic leakage were comparatively analyzed. Using the APACHE-II (Acute Physiology, Age, Chronic Health Evaluation) and MPI (Mannheim Peritonitis Index) scoring systems, different surgical approaches were examined in three patient groups (primary anastomosis, delayed anastomosis, and enterostomy).

Conditions

Postoperative Peritonitis; Anastomotic Leakage; Intestinal Perforation Small

Keywords

Surgical Anastomosis; Enterostomy; Mortality; Morbidity; Abdominal Closure Techniques; APACHE II; Secondary Peritonitis; Delayed Anastomosis; Primary Anastomosis; Mannheim Peritonitis Index

Outcome Measures

Primary Outcomes (1)

• Number of Patients with recurrent anastomotic leakage

  Number of patients in groups 1 and 2

  up to 2 months

Study Arms (3)

Group I. Primary anastomosis

Resection of the small bowel to place primary anastomosis into small intestine or transverse colon during relaparotomy.

Procedure: Primary anastomosis

Group II. Delayed anastomosis

Resection of the small intestine to place delayed anastomosis. After the closure of the afferent and efferent loops of the small intestine, anastomosis was not applied. A decompression probe was introduced into the upper small intestine. In 24-36 hours, delayed anastomosis was placed into the small intestine or transverse colon during the planned relaparotomy with arrested postoperative peritonitis.

Procedure: Delayed anastomosis

Group III. Enterostomy

Resection of the small intestine with enterostomy. In case there was no postoperative peritonitis relief and was organ dysfunction progression, anastomosis was not placed. The surgery was completed with enterostomy to perform open abdomen.

Procedure: Enterostomy

Interventions

Primary anastomosis PROCEDURE

Group I. Primary anastomosis

Delayed anastomosis PROCEDURE

Group II. Delayed anastomosis

Enterostomy PROCEDURE

Group III. Enterostomy

Eligibility Criteria

• Age: 19 Years - 76 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Local patients admitted to the clinic from around Altai Krai cities, suffering from postoperative peritonitis due to small-bowel perforations and small-bowel anastomotic leaks

You may qualify if:

• Clinical diagnosis of postoperastive peritonitis
• Conducting relaparotomy

You may not qualify if:

• Peritoneal cancer
• Multiple organ dysfunction syndrome

Sponsors & Collaborators

• Andrey Nikolayevich Zharikov: lead

Related Publications (3)

• Zharikov AN, Lubyansky VG, Aliev AR. Surgical techniques for open abdomen in patients with postoperative peritonitis. Bulletin of Medical Science 2(10):76-80, 2018. URL: http://www.agmu.ru/files/%E2%84%962(10)2018.pdf

  BACKGROUND

• Zharikov AN, Lubyansky VG, Aliev AR et al. Staged surgical treatment with temporary laparostomy in patients with postoperative peritonitis. Moscow Surgical Journal 1(41):10-14, 2015. URL: http://mossj.ru/journal/MOSSJ_2015/MXG_2015_01.pdf

  BACKGROUND

• Zharikov AN, Lubyansky VG, Zharikov AA. A differentiated approach to repeat small-bowel anastomoses in patients with postoperative peritonitis: a prospective cohort study. Eur J Trauma Emerg Surg. 2020 Oct;46(5):1055-1061. doi: 10.1007/s00068-019-01084-7. Epub 2019 Feb 4.

  PMID: 30719528 RESULT

MeSH Terms

Conditions

Anastomotic Leak; Peritonitis

Interventions

Enterostomy

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Intraabdominal Infections; Infections; Peritoneal Diseases; Digestive System Diseases

Intervention Hierarchy (Ancestors)

Digestive System Surgical Procedures; Surgical Procedures, Operative; Ostomy

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: September 26, 2018
• First Posted: October 1, 2018
• Study Start: May 1, 2010
• Primary Completion: December 1, 2025
• Study Completion: December 31, 2025
• Last Updated: July 26, 2021

Record last verified: 2021-07

Data Sharing

• IPD Sharing: Will not share