EFFICIENCY OF APPLICATION OF ENDOSURGICAL METHODS IN DIAGNOSTICS AND TREATMENTS OF COMBINED AND MULTIPLE ABDOMINAL INJURIES

Abstract

Aim. Improvement of the results of the treatment of patients with closed combined abdominal traumas. Material and methods. The study is based on the diagnosis and treatment of263 patients with combined abdominal and lower limbs traumas. The control group consisted of 126patients who were treated traditionally. 137patients were included in the main group that received video-endo-laparoscopy as a part of the complex treatment of abdominal component. Ultrasound and video-laparoscopy were used for the diagnosis of abdominal trauma component. Results. The video-endo-surgical method was used for all 137 patients of the main group. Hemoperitoneum was found in 86 (63.2%) patients. The reason was rupture of the liver in 48 (55.8%) cases, rupture of the spleen in 17 (19.8%) cases and, damage of intestines in 12 (14.0%) cases. In 9 (10.4%) cases injuries of abdominal organs were not visible. In that case, postabdominal hematoma reaching the level of the lower pole of kidneys was a source of a hemoperitoneum. Endo-video-laparoscopy was applied to 47patients as a treatment. Hemoperitoneum was caused by injury of the liver in 30 patients and by spleen trauma in 8 patients. The wound was moderately bleeding in all patients. All of them received video- endo-laparoscopic coagulation by monoelectrodes. Then the abdominal cavity sanation and subsequent drainage was performed. The frequency of extra-abdominal complications in the main group decreased in comparison with control by 2.6 times. Conclusion. Endosurgery is a high-informative and low-invasive method in diagnosis and treatment of the closed abdominal injuries. Its application as a treatment method for closed combined abdominal traumas is highly effective.