[Anesthesiologic complications in risk patients during and following upper and lower abdominal interventions]

It was the aim of this study to determine intraoperative and postoperative complications following lower abdominal or upper abdominal surgical interventions both quantitatively and qualitatively using the risk classification of the Mannheim risk check list. The types of surgical interventions in the upper and lower abdomen can be considered as comparable in respect of influence exercised on the homeostasis. The case records of 386 patients were evaluated retrospectively who had been operated on at the biliary tract, stomach (upper abdomen) or sigma, rectum or ileocaecum (lower abdomen). Preceding diseases were noted and recorded, and so were intraoperative and postoperative complications up to the 4th postoperative week. Statistical testing was effected by means of the chi-square test with alpha = 0.05. In accordance with the determined risk classifications, the incidence of preceding diseases increased for both the types of surgery (cardiovascular diseases and pulmonary diseases being the preliminary diseases recorded in this context). If intraoperative and postoperative complications are broken down, there is a dominance of bronchopulmonary complications after upper abdominal surgery postoperatively, and an equal distribution of overall intraoperative complications. The data prove that in assessing the risk according to the Mannheim risk check list, laparotomies of the upper abdomen are underestimated, so that this type of surgery should rank higher in risk check list than large-scale laparotomies at the sigma and rectum. Over and above this, the enhanced pulmonary risk of upper abdominal surgery continuous to be a proven fact.