Ultrasound-assisted focused open necrosectomy in the treatment of XXXX .

@entity1 @entity788 @entity295 @entity66 @entity656 @entity39 @entity260 @entity281 @entity7592
CONTEXT: The surgical treatment of @entity788 includes percutaneous @entity7592 and sequestrectomy in the late phase of the disease. OBJECTIVE: The aim of the study was to compare the conventional open necrosectomy (CON) approach with the alternative focused open necrosectomy (FON) approach in @entity1 with infected @entity39 and progression of @entity295 . METHODS: @entity1 with @entity656 were included in the study prospectively from January 2004 to July 2014. All @entity1 had been admitted with the first or a new @entity66 . Symptomatic large fluid collections were drained percutaneously. The step-up approach was used in @entity1 with several distant localizations of infected @entity39 . The methods were analysed by comparing the individual severity according to the ASA, APACHE II and SOFA scores, @entity281 rate, @entity260 rate and mortality. RESULTS: A total of 31 @entity1 were included in the FON group and 39 in the CON group. The incidence of @entity281 was similar in groups. More ASA III comorbid conditions, a higher APACHE II score, a more frequent need for renal replacement therapy was observed in the CON group. The @entity260 rate was in the range of 32% to 44%; mortality reached 6.5% in the FON group and 12.8% in the CON group. CONCLUSIONS: Comorbid conditions, organ failure, and @entity281 are the main risk factors in @entity1 with @entity788 . The step-up approach and perioperative ultrasonography navigation improves the clinical outcome and reduces the extent of invasive surgical intervention in @entity1 unsuited to other minimally invasive procedures.
