FEATURES OF MEDICAL AND REHABILITATION MEASURES IN THE POSTOPERATIVE PERIOD IN PATIENTS WITH PERITONITIS ON THE BACKGROUND OF OBESITY

Abstract

The article examines the issue of specifics of treatment and rehabilitation measures in the postoperative period in patients with peritonitis on the background of obesity based on observation of such patients and analysis of known literary sources. The purpose of the work is to determine the main features of treatment measures, prevention of complications and the introduction of active rehabilitation measures in the postoperative period in obese patients who underwent surgery due to diseases of the abdominal cavity that were complicated by peritonitis. Results and methods. The materials of the article are based on the observation of 468 obese patients who were treated in the surgical clinics of the Department of General Surgery of the National Pirogov Memorial Medical University (Vinnytsya) from 2003 to 2023. Iin 97 of them were complicated by peritonitis. The 1st group included 202 patients (including 51 with peritonitis) treated from 2003 to 2012, and the 2nd group – 266 patients (including 46 with peritonitis) treated from 2013 to 2023. Thanks to the study of the causes of the peculiarities of development, course and complications during operations on abdominal organs complicated by peritonitis in obese people and the introduction of new modern technologies, the number of all postoperative complications decreased from 54.90% (in the 1st group) to 23.91 % (in the 2nd group). Conclusions. The main reason for the unsatisfactory results of treatment and rehabilitation measures in patients of group 1 should be considered the untimely application for medical help to a medical institution due to the masked course of diseases against the background of obesity, the underdevelopment of the Institute of Family Medicine at that time and the lack of modern diagnostic and treatment equipment in 2003–2012 years. The study of the features of the development, course and diagnosis of acute surgical diseases of the abdominal cavity in obese persons and the introduction of appropriate treatment and rehabilitation measures in the postoperative period made it possible to improve the results of treatment of obese patients diagnosed with peritonitis. Patients with peritonitis who suffer from obesity are a very difficult contingent, for the treatment of which medical personnel need to be specially trained and trained.