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The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
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InstructionsInformed consent policyContract offerEASE GuidelinesICJME CriteriaWAME Recommendations on ChatGPT and Chatbots in Relation to Scholarly Publications
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Obstetrics and Gynegology2026№10

Organ-sparing surgery with vacuum-assisted laparostomy for advanced obstetric peritonitis: a series of 58 consecutive cases

DOI
https://dx.doi.org/10.18565/aig.2026.127

Churina D.E., Makarenko T.A., Cherdantsev D.V.

Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Ministry of Health of Russia, Krasnoyarsk, Russia

Background. Obstetric peritonitis is a severe purulent-septic complication following cesarean section, with an incidence ranging from 0.1% to 1.5%. Mortality from postpartum sepsis accounts for 37–40% of maternal deaths. The primary challenge in surgical management lies in balancing the need for radical source control with the desire to preserve the uterus in young women of reproductive age.
Objective. To improve surgical outcomes in patients with advanced obstetric peritonitis by presenting clinical experience with a staged surgical approach using vacuum-assisted laparostomy in a consecutive series of patients after abdominal delivery.
Materials and methods. We conducted a retrospective analysis of a consecutive case series of 58 patients with obstetric peritonitis, which developed after cesarean section, treated at the Krasnoyarsk Regional Clinical Hospital between 2018 and 2025. The study was conducted in accordance with the PROCESS 2023 guideline. All procedures utilized vacuum-assisted laparostomy, performed according to an original technique (Russian Federation Patent No. 2816058). Statistical analyses were descriptive. Continuous variables are summarized as medians with first and third quartiles, and categorical variables as counts and percentages.
Results. The uterus was preserved in 49 (84.5%) of the 58 patients. Vacuum-assisted laparostomy was employed in 56 women (96.6%), and hysterectomy was avoided in 49 of these patients, representing 87.5% of those who underwent laparostomy. No deaths occurred in the case series (0%). Two patients became pregnant again after discharge and subsequently had term deliveries. No intraoperative injuries to adjacent organs were observed. Complications, characterized by failure of vacuum-assisted laparostomy (including progression of sepsis, absence of favorable laboratory trends, and total myometrial necrosis), occurred in 7 patients and necessitated hysterectomy.
Conclusion. In this case series, a staged surgical approach using vacuum-assisted laparostomy in patients with obstetric peritonitis was associated with a high rate of uterine preservation (84.5%) and zero mortality. These findings suggest the potential for preserving reproductive function in some patients experiencing this complication.

Authors' contributions. Churina D.E. – conception of the study, clinical data collection and analysis, statistical analysis, drafting of the manuscript; Makarenko T.A. – study design, editing of the manuscript, clinical supervision; Cherdantsev D.V. – development of the vacuum-assisted laparostomy method, performance of surgical interventions, drafting of the manuscript.
Conflicts of interest. The authors have no conflicts of interest to declare.
Funding. The study was conducted within the framework of the state R&D assignment (EGISU No. 122040600142-6) titled "New standards for the treatment of purulent-inflammatory postpartum uterine diseases using microbiological testing for relevant pathogens" (2022–2024).
Ethical Approval. The study was reviewed and approved by the Research Ethics Committee of the Prof. V.F. Voino-Yasenetsky KrasSMU (protocol No. 15/04-2025 dated 04/15/2025).
Generative Artificial Intelligence. No artificial intelligence tools were used in the preparation of this manuscript.
Patient Consent for Publication. All patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement. The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
For citation: Churina D.E., Makarenko T.A., Cherdantsev D.V. Organ-sparing surgery with vacuum-assisted laparostomy for advanced obstetric peritonitis: a series of 58 consecutive cases.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (10): 68-80 (in Russian)
https://dx.doi.org/10.18565/aig.2026.127

Keywords

obstetric peritonitis
case series
PROCESS
vacuum-assisted laparostomy
organ-preserving treatment
hysterectomy
cesarean section
postpartum purulent-septic complications
Full text (in Russian)

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Received 20.04.2026

Accepted 02.10.2026

About the Authors

Darya E. Churina, PhD, Associate Professor at the Department of Operative Gynecology, Institute of Postgraduate Education, Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Ministry of Health of the Russian Federation, 660022, Russia, Krasnoyarsk Territory, Krasnoyarsk, Partizan Zheleznyak str., 1, +7(923)376-94-33, dashsemch@mail.ru, https://orcid.org/0000-0001-7516-5203
Tatiana A. Makarenko, Dr. Med. Sci., Professor, Head of the Department of Operative Gynecology, Institute of Postgraduate Education, Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Ministry of Health of the Russian Federation, 660022, Krasnoyarsk Territory, Krasnoyarsk, Partizan Zheleznyak str., 1,
+7(904)895-47-99, makarenko7777@yandex.ru, https://orcid.org/0000-0002-2899-8103
Dmitry V. Cherdantsev, Dr. Med. Sci., Professor, Head of the Department of Hospital Surgery named after Professor A.M. Dykhno with a Postgraduate Education Course, Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Ministry of Health of the Russian Federation, 660022, Krasnoyarsk Territory, Krasnoyarsk,
Partizan Zheleznyak str., 1, +7(902)-940-78-52, gs7@mail.ru, https://orcid.org/0000-0002-4743-4565
Corresponding author: Darya E. Churina, dashsemch@mail.ru

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