Abstract:
Postoperative peritonitis remains a critical challenge in contemporary surgery, with persistent complications despite conventional antibiotic therapy leading to increased mortality and prolonged recovery periods. This study investigates the therapeutic efficacy of direct endolymphatic drug therapy (TTBET) in managing persistent postoperative peritonitis following acute appendicitis. The research examined 66 patients with appendicular peritonitis treated in Tashkent surgical clinics, divided into a main group receiving endolymphatic therapy via catheterized peripheral lymphatic vessels (n=36) and a control group receiving conventional treatment (n=30). Immunological parameters including T-lymphocytes, B-lymphocytes, immunoglobulins (IgG, IgA, IgM), and neutrophil phagocytic activity were measured at baseline and day 14 post-treatment using standardized biochemical and immunological assays. Results demonstrated statistically significant improvements in the endolymphatic therapy group, with T-lymphocyte counts increasing 1.41-fold compared to controls (p=0.0022), IgG levels rising 1.7-fold versus 1.49-fold in controls, and neutrophil phagocytic activity improving 1.68-fold versus negligible change in the control group. This study provides novel evidence that endolymphatic administration achieves superior drug concentration at inflammatory sites while simultaneously modulating immune responses through direct lymphatic system engagement. The findings suggest endolymphatic therapy represents a pathogenetically sound approach for managing persistent peritonitis, offering reduced antibiotic doses, enhanced immunological recovery, and improved clinical outcomes, warranting broader clinical implementation in surgical infection management protocols.
Keywords : Endolymphatic Drug Administration, Postoperative Peritonitis Management, Lymphatic System Therapeutics, Immunomodulation Surgical Infections, Regional Antibiotic Delivery, Purulent-Septic Complications
Highlight :
- Endolymphatic therapy significantly increases T-lymphocytes, immunoglobulins IgG/IgM, and neutrophil phagocytic activity
- Main group shows 1.41-fold T-lymphocyte increase versus minimal improvement in control group
- Treatment normalizes microcirculation and reduces postoperative complications in appendicular peritonitis patients.
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References
A. M. Usarov, “Immunological Foundations of Lymphatic Drug Administration in Appendicular Peritonitis,” Miasto Przyszłości Kielce, vol. 53, no. 4, pp. 795–800, 2024. [Online]. Available: https://miastoprzyszlosci.com.pl/index.php/mp/article/view/4937
D. A. Abdurazzakova, A. M. Ashurmetov, and M. N. Agzamova, “Efficiency of Endolymphatic Drug Administration,” Young Scientist, no. 9, pp. 61–62, 2018. [Online]. Available: [https://moluch.ru/archive/](https://moluch.ru/archive/)
M. N. Agzamova, D. A. Abdurazzakova, and F. M. Ismailov, “Study of Microbial Flora in Peritonitis,” Young Scientist, no. 1, pp. 33–34, 2018. [Online]. Available: [https://moluch.ru/archive/](https://moluch.ru/archive/)
M. N. Agzamova, K. F. Zuparov, and T. Z. Zikrilla, “Oxidative Status During Alloplasty in Patients With Postoperative Ventral Hernia,” Infection, Immunity and Pharmacology, vol. 1, no. 1, pp. 5–9, 1999.
M. D. Akhmedov, A. I. Akhmedov, and A. A. Tursumetov, “Cytochrome Oxidase Activity of Liver Parenchyma at Various Periods of Ischemia and Obstructive Jaundice,” European Science, no. 2, vol. 44, pp. 71–75, 2019. [Online]. Available: [https://euro-science.org](https://euro-science.org)
A. M. Ashurmetov, D. A. Abdurazzakova, and S. N. Navruzov, “Lymphoimmunostimulation in Diffuse Purulent Peritonitis,” Young Scientist, no. 7, pp. 103–105, 2018. [Online]. Available: [https://moluch.ru/archive/](https://moluch.ru/archive/)
Kh. M. Jafarov, K. M. Zhafarov, and I. S. Melnik, “Method of Treating Purulent-Inflammatory Diseases in Patients With Diabetes Mellitus,” Palliative Medicine and Rehabilitation, no. 2–3, pp. 110–113, 2002.
F. M. Ismailov, M. N. Agzamova, and S. R. Mekhmonov, “Causes of Death in Emergency Conditions of the Abdominal Organs,” Young Scientist, no. 8, pp. 44–46, 2018. [Online]. Available: [https://moluch.ru/archive/](https://moluch.ru/archive/)
S. N. Navruzov, Sh. R. Mekhmonov, and K. S. Dolimov, “Extended and Combined Surgeries for Large Bowel Obstruction,” Bulletin of the Association of Physicians of Uzbekistan, vol. 3, no. 1, pp. 20–23, 2003.
A. Abdumajidov, J. K. Mirzakhidovich, and T. A. Abdumalikovich, “Complex Treatment of Pyo-Inflammatory Diseases in Patients With Diabetes Mellitus,” Central Asian Journal of Pediatrics, vol. 2, no. 3, pp. 57–59, 2019.
A. I. Akhmedov, A. A. Tursumetov, and K. M. Zhafarov, “Features of Allohernioplasty for Postoperative Ventral Hernias in the On-Lay Position Under Conditions of Infection,” European Journal of Molecular and Clinical Medicine, vol. 7, no. 3, pp. 3897–3905, 2020. [Online]. Available: [https://ejmcm.com](https://ejmcm.com)
V. M. Buyanov, G. V. Rodoman, and L. A. Laberko, “Modern Methods for Assessing Endogenous Intoxication in Diffuse Peritonitis,” in Proceedings of the 1st Moscow International Congress of Surgeons, Moscow, Russia, 1995, pp. 16–17.
A. S. Ermolov, E. E. Udovskiy, and A. R. Grigoryan, “Nonspecific Humoral Immunity Status in Endolymphatic Antibiotic Therapy of Surgical Infections,” Khirurgiya, no. 1, pp. 76–79, 1987.
V. A. Golbraikh, Endolymphatic Therapy in the Complex Treatment of Patients With Purulent-Inflammatory Diseases of the Abdominal Organs, Ph.D. dissertation abstract, Moscow, Russia: Sechenov First Moscow Medical Institute, 1998.
K. M. Zhafarov and I. S. Melnik, “Immediate Results of Surgical Treatment of Patients With Strangulated Ventral Hernia of the Anterior Abdominal Wall,” Asian Pacific Journal of Environment and Cancer, vol. 4, no. S1, pp. 13–14, 2021. doi: 10.31557/apjec.2021.4.S1.13
J. K. Mirzakhidovich, T. A. Abdumalikovich, and A. A. Ibrogimovich, “Prevention of Postoperative Wound Complications in Rapped Abdominal Hernia,” Annals of the Romanian Society for Cell Biology, vol. 25, no. 6, pp. 6473–6484, 2021. [Online]. Available: [https://annalsofrscb.ro](https://annalsofrscb.ro)