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Urgent abdominal re-explorations
Haluk Recai Unalp1, Erdinc Kamer, Haldun Kar
1General Surgeon, Department of General Surgery, 4th General Surgery Clinic, Izmir Ataturk Training and Research Hospital, Izmir, Turkey. drhru@mynet.com.
World Journal of Emergency Surgery : WJES
|June 9, 2006
Summary
Urgent abdominal re-explorations (UARs) after surgery have high mortality, especially with gastrointestinal (GIS) surgery or infections. Success of the initial operation is key to reducing these risks.
Area of Science:
- Surgical Outcomes
- Abdominal Surgery Complications
- Emergency Medicine
Background:
- Complications following abdominal surgeries often necessitate Urgent Abdominal Re-explorations (UARs).
- These life-saving operations aim to manage post-surgical complications.
- Evaluating UARs is crucial for improving patient outcomes.
Purpose of the Study:
- To determine the reasons for performing UARs.
- To assess the outcomes of relaparotomies (RLs).
- To identify factors influencing mortality after UARs.
Main Methods:
- Retrospective analysis of patients undergoing early RLs for complicated abdominal surgeries (2000-2004).
- Data collected included demographics, initial diagnoses, surgical complications, and UAR details.
- Statistical analysis employed chi-square and Fisher exact tests.
Main Results:
- UARs were performed in 1.8% of cases (81/4410).
- Common causes included intestinal repair leakage (41.97%), hemorrhage (18.51%), and perforation (9.87%).
- Overall mortality was 34.97%, with sepsis/multiple organ failure (MOF) being the most frequent cause (55.5%). Mortality was higher with multiple UARs and after GIS surgery.
Conclusions:
- Urgent Abdominal Re-explorations carry high mortality rates, particularly following GIS surgery or infectious complications.
- Reducing mortality hinges on the success of the initial surgical procedure.
- Effective management of initial abdominal surgeries is critical to prevent severe complications requiring UARs.