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Repeat laparotomy in a developing world tertiary level surgical service
Matthias F Scriba1, Grant L Laing1, John L Bruce1
1Department of Surgery, Pietermaritzburg Hospital Complex, University of KwaZulu Natal, Townbush Road, Pietermaritzburg, KwaZulu-Natal, South Africa.
Background:
Repeat laparotomy is associated with significant morbidity and mortality; however, developing world data are scarce. This study reviews the spectrum and outcomes of relaparotomy in a developing world setting.
Methods:
Prospectively collected data from adult patients needing repeat laparotomy over an 18-month period were analyzed.
Results:
Relaparotomy rate was 24% and average age was 38 years with a male predominance (70%). Appendicitis and trauma were the most common diagnoses. Planned relaparotomy rate was high (41%); however, negative relaparotomy rate was only 9%. Need for intensive care unit admission (51%) and morbidity rate (64%) were both high, but overall mortality rate was 14%. Patients requiring multiple relaparotomies had further worsened outcomes.
Conclusions:
The need for repeat laparotomy in the developing world is high and it is associated with significant morbidity and need for intensive care unit admission. However, mortality rates and negative repeat laparotomy rates were low.
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