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New Indian Journal of Surgery

Volume  11, Issue 2, April-June 2020, Pages 230-236
 

Original Article

Retrospective Study on Patients Undergoing Laparotomy to Assess the Risk Factors of Re-Laparotomy

J Vaishnavi1, R Chitra2, S Rajeshkumar3, D Vinoth4

1,2Assistant Professor, 3Professor, 4Junior Resident, Department of General Surgery, PSG Institute of Medical Sciences and Research, Peelamedu Pudur, Coimbatore, Tamil Nadu, 641004, India.

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DOI: https://dx.doi.org/10.21088/nijs.0976.4747.11220.25

Abstract

 

Introduction: Abdominal surgery that has to be redone in association with initial surgery is referred to as re laparotomy. Re-laparotomy is associated with 22 to 513% morbidity and mortality, therefore it’s the final choice of surgery. The main aim of this study was to find out the incidence of re- laparotomy and to identify the risk factors i.e. predictors of relaparotomy in patients undergoing general surgery operations.
Materials and Methodology: This was a retrospective study involving 100 patients, done from 1st Jan 2016 till 1st June 2017 Patients with age more than 18 years, those requiring laparotomy for both general and trauma surgery were included. Those with initial laparostomy, with only flank drain placement, any Laparotomies during colostomy or ileostomy closure, those with Initial laparoscopic procedure, minimal
invasive procedure like ultrasound guided drainage etc. Were excluded. Data was analyzed using SPSS Software. The Results were expressed in percentage. Associations were analyzed using chi-square or ‘t
test depending on outcome variables. Results: The incidence of revision laparotomy in this study was 7% and the incidence of second revision laparotomy was 1%. The indications for relaparotomy were anastamotic leak 2/7 (20%), burst abdomen 2/7 (20%), pancreatic injury 1/7 (10%),
bladder injury 1/7 (10%), negative laparotomy 1/7 (10%). The variables with significant p-value are systemic hypertension, COPD, CAD, intra-op and post-op inotoropic support, wound infection, wound dehiscence and intra-abdominal abscess. These data can thus be used in future to formulate a prediction scoring system.
Keywords: Laparotomy; Re-lapaprotomy; Post-op peritonitis; Burst abdomen.
 


Corresponding Author : R Chitra