Inflammatory peritoneal reaction after perforated appendicitis: Continuous peritoneal lavage versus non lavage

Andreas Schwarz, E. Bölke, M. Peiper, J. Schulte am Esch, G. Steinbach, M. van Griensven, K. Orth

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Introduction: Bacterial peritonitis is a severe medical condition associated with a natural mortality rate of 80-100%. Progress in surgical techniques, new developments in intensive care medicine and antibiotic therapy reduced this rate significantly. Aim of this study was to evaluate sepsis parameter in perforated appendicitis and different postoperative management. Methods: In 50 consecutive patients with diffuse bacterial peritonitis and perforated appendicitis, laparotomy was performed. Subsequently, 25 patients were treated with adjuvant, continuous peritoneal lavage (CPL) using standard peritoneal dialysis (CAPD)-solution The remaining 25 patients were peritoneally drained without postoperative irrigation (Non-CPL). In all patients endotoxin, tumor necrosis factor-α (TNF-α), interleukin (IL-6), C-reactive protein (CRP) and myeloid-related protein (MRP-8, MRP-14 and Heterocomplex) were determined. Results: No difference in clinical outcome between CPL and Non-CPL could be established. An uncomplicated clinical outcome was associated with lower levels of inflammation markers. Furthermore, clinical data revealed that mortality depended on co-morbidity, and patient's age. Summary: In perforated appendicitis a faster decrease of mediator release could not be achieved with either method. In addition, no difference could be established for the clinical parameters like hospitalization, duration of intensive care and morbidity.

Original languageEnglish
Pages (from-to)200-205
Number of pages6
JournalEuropean Journal of Medical Research
Volume12
Issue number5
StatePublished - 29 May 2007
Externally publishedYes

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