Vacuum-assisted laparostomy in severe abdominal trauma and urgent abdominal pathology with compartment syndrome, peritonitis and sepsis: Comparison with other options for multistage surgical treatment (systematic review and meta-analysis)

Background. The concept of multistage surgical treatment of patients has been established in surgery rather recently and therefore the discussions on the expediency of using a particular surgical technique in a specific situation still continue. Vacuum-assisted laparostomy is being widely implemented into clinical practice for the treatment of abdominal compartment syndrome, severe peritonitis and abdominal trauma, but the indications and advantages of this method are not clearly defined yet.The aim of the study. To conduct a systematic review and meta-analysis on the comparison of the effectiveness of vacuum-assisted laparostomy with various variants of relaparotomy and laparostomy without negative pressure therapy in  the  treatment of patients with urgent abdominal pathology and abdominal trauma complicated by widespread peritonitis, sepsis or compartment syndrome.Material and methods. A systematic literature search was conducted in accordance with the recommendations of “Preferred Reporting Items for Systematic Reviews and Meta-Analyses”. We carried out the analysis of non-randomized (since January 2007 until August 6, 2022) and randomized (without time limits for the start of the study and until August 6, 2022) studies from the electronic databases eLibrary, PubMed, Cochrane Library, Science Direct, Google Scholar Search, Mendeley.Results. Vacuum-assisted laparostomy causes statistically significant shortening of the time of treatment of patients in the ICU and in hospital and a decrease in  postoperative mortality compared to other variants of laparostomy without vacuum assistance.Conclusion. To obtain data of a higher level of evidence and higher grade of recommendations, it is necessary to further conduct systematic reviews and meta-analyses based on randomized clinical studies. 

[1]  D. Sichinava,et al.  Vacuum-assisted laparostomy with staged peritoneal lavage in management of secondary postoperative diffuse peritonitis: a prospective comparative non-randomised clinical trial , 2022, Kuban Scientific Medical Bulletin.

[2]  V. V. Fedyushkin,et al.  Vacuum-assisted healing of various-aetiology wounds: A systematic review , 2021, Kuban Scientific Medical Bulletin.

[3]  И. Б. Уваров,et al.  ИНТРААБДОМИНАЛЬНОЕ И ТРАНСАНАЛЬНОЕ ВАКУУМНОЕ ДРЕНИРОВАНИЕ ПРИ ЛЕЧЕНИИ НЕСОСТОЯТЕЛЬНОСТИ КОЛОРЕКТАЛЬНОГО АНАСТОМОЗА (клинический случай) , 2020 .

[4]  S. K. Piper,et al.  Intraabdominal continuous negative pressure therapy for secondary peritonitis: an observational trial in a maximum care center , 2020, Acta chirurgica Belgica.

[5]  S. Petrov,et al.  Surgical Treatment of Patients With Tertiary Peritonitis , 2019, Novosti Khirurgii.

[6]  А. Ю. Корольков,et al.  ОПЫТ УСПЕШНОГО ПРИМЕНЕНИЯ ВАКУУМНОЙ ТЕРАПИИ В ЛЕЧЕНИИ НЕСОСТОЯТЕЛЬНОСТИ КУЛЬТИ ЖЕЛУДКА ПОСЛЕ ЛАПАРОСКОПИЧЕСКОЙ ПРОДОЛЬНОЙ РЕЗЕКЦИИ: КЛИНИЧЕСКОЕ НАБЛЮДЕНИЕ , 2018 .

[7]  A. A. Martynov,et al.  LAPAROSTOMIA: HISTORY OF DEVELOPMENT AND TECHNICAL ASPECTS OF IMPLEMENTATION , 2018 .

[8]  A. E. Popov,et al.  POSSIBILITIES OF IMPROVING THE EFFICIENCY OF PERIOPERATIVE SANITATION OF ABDOMINAL CAVITY AT PERITONITIS , 2018 .

[9]  V. Shapkina.  OUR EXPERIENCE ON USAGE OF VACUUM-ASSISTED CLOSURE WITH FRACTIONAL FLOW-INSTILLATION METHOD OF THE OPEN ABDOMEN IN DIFFUSE PERITONITIS TREATMENT , 2017 .

[10]  M. Boermeester,et al.  The role of open abdomen in non-trauma patient: WSES Consensus Paper , 2017, World Journal of Emergency Surgery.

[11]  R. Gunnarsson,et al.  Complications and Mortality Associated with Temporary Abdominal Closure Techniques: A Systematic Review and Meta-Analysis , 2017, The American surgeon.

[12]  Pablo Sibaja,et al.  Management of the open abdomen using negative pressure wound therapy with instillation in severe abdominal sepsis , 2016, International journal of surgery case reports.

[13]  R. Yakubov,et al.  NEGATIVE PRESSURE THERAPY IN COMPLEX PROGRAM FOR TREATMENT OF PANCREATOGENIC SEPSIS , 2017 .

[14]  D. Bartsch,et al.  High risk of fistula formation in vacuum-assisted closure therapy in patients with open abdomen due to secondary peritonitis—a retrospective analysis , 2016, Langenbeck's Archives of Surgery.

[15]  A. Buczkowski,et al.  Open abdomen with negative pressure device vs primary abdominal closure for the management of surgical abdominal sepsis: a retrospective review. , 2016, American journal of surgery.

[16]  N. Tai,et al.  Management and closure of the open abdomen after damage control laparotomy for trauma. A systematic review and meta-analysis. , 2016, Injury.

[17]  G. Popivanov,et al.  Open abdomen and VAC® in severe diffuse peritonitis , 2015, Journal of the Royal Army Medical Corps.

[18]  D. V. Cherdantsev,et al.  CLINICAL CASE OF SUCCESSFUL TREATMENT OF PATIENTS WITH SEVERE INFECTED PANCREATIC NECROSIS , 2016 .

[19]  E. Moore,et al.  IROA: the International Register of Open Abdomen. , 2015, World Journal of Emergency Surgery.

[20]  E. Moore,et al.  The role of the open abdomen procedure in managing severe abdominal sepsis: WSES position paper , 2015, World Journal of Emergency Surgery.

[21]  R. Manfredi,et al.  The open abdomen, indications, management and definitive closure , 2015, World Journal of Emergency Surgery.

[22]  E. Utiyama,et al.  Open abdomen management: single institution experience. , 2015, Revista do Colegio Brasileiro de Cirurgioes.

[23]  M. Boermeester,et al.  Systematic Review and Meta-analysis of the Open Abdomen and Temporary Abdominal Closure Techniques in Non-trauma Patients , 2015, World Journal of Surgery.

[24]  N. Qvist,et al.  The open abdomen: temporary closure with a modified negative pressure therapy technique , 2014, International wound journal.

[25]  K. Sapalidis,et al.  The Value of Vacuum-Assisted Closure in Septic Patients Treated with Laparostomy , 2012, The American surgeon.

[26]  S. Schneeberger,et al.  Open Abdomen Treatment with Dynamic Sutures and Topical Negative Pressure Resulting in a High Primary Fascia Closure Rate , 2012, World Journal of Surgery.

[27]  N. Cáceres Alvarado,et al.  [Vacuum assisted closure in open abdomen and deferred closure: experience in 23 patients]. , 2012, Cirugia espanola.

[28]  M. Schmelzle,et al.  Long-Term Vacuum-Assisted Closure in Open Abdomen due to Secondary Peritonitis: A Retrospective Evaluation of a Selected Group of Patients , 2010, Digestive Surgery.

[29]  G. Zagli,et al.  Vacuum-assisted closure device enhances recovery of critically ill patients following emergency surgical procedures , 2009, Critical care.

[30]  I. Shaikh,et al.  Topical negative pressure in managing severe peritonitis: a positive contribution? , 2009, World journal of gastroenterology.

[31]  D. Moher,et al.  Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement , 2009, BMJ : British Medical Journal.

[32]  U. Zingg,et al.  Treatment of the Open Abdomen with the Commercially Available Vacuum-Assisted Closure System in Patients with Abdominal Sepsis , 2008, World Journal of Surgery.

[33]  N. Demartines,et al.  Prospective evaluation of vacuum-assisted closure in abdominal compartment syndrome and severe abdominal sepsis. , 2007, Journal of the American College of Surgeons.

[34]  D. Gouma,et al.  Comparison of on-demand vs planned relaparotomy strategy in patients with severe peritonitis: a randomized trial. , 2007, JAMA.

[35]  Philip Smith,et al.  Experience with vacuum-pack temporary abdominal wound closure in 258 trauma and general and vascular surgical patients. , 2007, Journal of the American College of Surgeons.

[36]  D. Burke,et al.  The use of vacuum‐assisted closure of abdominal wounds: a word of caution , 2007, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.

[37]  E. Luque-de-León,et al.  Open versus closed management of the abdomen in the surgical treatment of severe secondary peritonitis: a randomized clinical trial. , 2007, Surgical infections.