Effectiveness of local and intravenous ozone therapy in minimally invasive treatment of liver abscesses

Objective. To develop a methodological algorithm for improving the effectiveness of surgical treatment of hollow formations in the liver, as well as a new surgical technique for local and intravenous administration of an optimized dose of ozone solution during percutaneous puncture aspiration, laparoscopic or percutaneous drainage catheterization. Materials and methods. A comparative analysis of the treatment outcomes of 128 patients who underwent minimally invasive surgery for liver abscess in 2016–2024 was performed. There were 82 women (64.1%) and 46 men (35.9%). In 98 (76.6%) patients, the liver abscess was located in the right lobe, and in 30 (23.4%) in the left lobe. The patients were divided into two groups: the first group consisted of 32 patients who underwent percutaneous puncture aspiration, and the second group consisted of 96 patients who underwent laparoscopic or percutaneous drainage catheterization. The clinical and anamnestic data of patients, length of hospital stay, treatment outcomes, and mortality were analyzed. Results. Of the 128 patients, 121 (94.5%) had complete resolution of liver abscess by the 4th–5th week, and treatment was successfully completed. In 5 (3.9%) patients, the abscess cavity decreased by 50% by the 8th–10th week. In 1 (0.8%) patient, the abscess did not completely resolve by the 5th–6th month. One (0.8%) patient died. No serious complications were observed in patients in either group. Excellent treatment results were achieved with the use of an optimized dose of ozone solution in both groups. Conclusions. The best minimally invasive method is catheterization. Continuous use of a drainage catheter is safe and effective. Local application of an optimized dose of ozonated solution and its intravenous administration for 5–7–10 days is simple, easy, cost–effective, and effective. The number of patients who recovered increased by 1.1–1.5 times, the frequency of complications decreased by 1.3–1.7 times, and mortality decreased by 1.7–2.1 times.