Abstract
Objective：Abdominal infection is a major cause of sepsis, and it can be severe, particularly when caused by lower gastrointestinal tract perforation. Multidisciplinary treatment including an operative procedure is indispensable for the survival of the patient. Materials and Methods：21 patients with a colorectal perforation underwent emergency surgery in our hospital from April 2010 to August 2013. We examined the validity of the surgical procedure and perioperative management including PMX-DHP. Results：Hartman's procedure was performed in 18 patients, in 2 severe cases of whom abbreviated surgery was undertaken. The average score of the Acute Physiology And Chronic Health Evaluation (APACHE) Ⅱ was 21.7 points, the 28-day survival rate was 95％ and the standardized mortality ratio was 0.11. Early Goal-Directed Therapy(EGDT) was achieved for all patients and direct hemoperfusion with polymyxin-B immobilized fiber(PMX-DHP) was induced for 8 patients with improvement in hemodynamics being confirmed in all patients. Conclusion：Our strategy for dealing with colorectal perforation contributes to the improvement of a high survival rate and the validity of our approach has been shown.
