SURGICAL MANAGEMENT OF ABDOMINAL SEPSIS: CURRENT EVIDENCE, MINIMALLY INVASIVE STRATEGIES, AND CLINICAL OUTCOMES
DOI:
https://doi.org/10.56238/levv17n58-022Keywords:
Abdominal Sepsis, Emergency Surgery, Source Control, Laparotomy, Laparoscopy, MortalityAbstract
Abdominal sepsis remains one of the most critical challenges in emergency surgery, accounting for high mortality rates among critically ill patients. Prompt surgical source control, combined with early antibiotic therapy and hemodynamic stabilization, is the cornerstone of effective management. This study aimed to systematically review recent evidence on the surgical treatment of abdominal sepsis, focusing on intervention timing, minimally invasive strategies, and clinical outcomes. A systematic review was conducted following PRISMA guidelines, using PubMed, Scopus, Web of Science, and ScienceDirect databases, covering studies published between 2010 and 2025. Eight key studies were selected, including international guidelines, multicenter cohorts, and clinical reviews. The findings highlighted that delays of more than six hours in surgical source control significantly increase mortality. In hemodynamically stable patients, laparoscopic approaches were associated with better postoperative outcomes, shorter hospital stays, and reduced inflammatory response. Conversely, in severe cases, staged surgery, open abdomen techniques, and relook procedures showed favorable outcomes in complex peritonitis. Additionally, intra-abdominal hypertension, the gut microbiome's role, and the need for multidisciplinary care were emphasized as integral components of a comprehensive strategy. In conclusion, individualized and timely surgical intervention is essential for improving survival in patients with abdominal sepsis.
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