The effectiveness of laparoscopic technique in combination with laser irradiation in acute perforated gastroduodenal ulcers

Purpose. To study effects of intravenous laser blood irradiation (ILBI) with laser debridement of wounds and abdominal cavity, which are added to the standard laparoscopic and surgical treatment of perforated gastroduodenal ulcers. Material and methods. 31 patient with perforated gastroduodenal ulcers and symptoms of peritonitis were treated in the hospital. They were divided into two groups. In the control group (n = 19), after preoperative preparation patients were operated laparoscopically with suturing a perforated ulcer, sanitation and drainage of the abdominal cavity. In the main group (n = 12), after preoperative preparation, laparoscopic suturing of a perforated gastroduodenal ulcer in combination with ILBI, laser debridement of the wound and abdominal cavity were made. On admission, all patients were examined by the standard scheme: clinical examination, instrumental examinations (R-scan of chest, ultrasound examination of abdominal organs, electrocardiography, external respiration). To solve the task, the generally accepted clinical examination steps were added with biochemical testings (dynamics of changes in free radical lipid oxidation processes and in antioxidant blood protection parameters). Results. When treating patients with perforated gastroduodenal ulcers laparoscopically in combination with ILBI and laser debridement of wounds and the abdominal cavity, the researchers noted the following in the main group: better indices of average mass molecules (MSM), less blood intoxication, immunity increase – what, in its turn, leads to the increase in lipid peroxidation and antioxidant protection at the final stage of treatment. Such positive effects have decreased the number of postoperative complications as well as the average duration of treatment, if to compare with traditional care, thus ultimately, leading to less financial costs. Conclusion. The laparoscopic technique in combination with ILBI and laser wound and abdominal sanitation in patients with perforated gastroduodenal ulcers is a promising modality which has a high medical and social importance.

gastroduodenal ulcer, ulcer perforation, laparoscopic surgery, intravenous laser blood irradiation, laser debridement of wounds and abdominal cavity

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