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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.

American Journal of Surgery
|June 28, 2015
PubMed
Summary
This summary is machine-generated.

Repeat laparotomy is common in developing nations, leading to high intensive care unit admission and morbidity. However, mortality and negative repeat laparotomy rates were found to be low in this study.

Keywords:
Developing worldOutcomesRelaparotomy

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Area of Science:

  • Surgical outcomes
  • Global surgery

Background:

  • Repeat laparotomy data from developing countries are limited.
  • This study addresses the spectrum and outcomes of relaparotomy in a developing world context.

Purpose of the Study:

  • To analyze the incidence, indications, and outcomes of repeat laparotomy in a developing country.
  • To assess the morbidity and mortality associated with relaparotomy in this setting.

Main Methods:

  • Prospective data collection from adult patients requiring repeat laparotomy over 18 months.
  • Analysis of relaparotomy rates, diagnoses, planned vs. unplanned procedures, and outcomes.

Main Results:

  • The relaparotomy rate was 24%, with appendicitis and trauma as primary indications.
  • High rates of intensive care unit admission (51%) and morbidity (64%) were observed.
  • Mortality rate was 14%, with a low negative relaparotomy rate of 9%.

Conclusions:

  • Repeat laparotomy is frequently needed in developing countries, associated with substantial morbidity and intensive care unit utilization.
  • Despite high morbidity, mortality and negative repeat laparotomy rates were notably low.
  • Outcomes worsen significantly with multiple repeat laparotomies.