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Urgent Redo-Laparotomies: Patterns and Outcome-A Single Centre Experience
Rabin Koirala1, Naimish Mehta2, Vibha Varma1
1Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India 110060C.
The Indian Journal of Surgery
|August 7, 2015
Summary
Unplanned repeat abdominal surgeries, or redo laparotomies, are often necessitated by complications like bleeding or abscesses. These urgent procedures carry a high mortality rate, with sepsis and organ failure being primary causes of death.
Area of Science:
- Gastroenterology
- Surgical Outcomes
- Abdominal Surgery
Background:
- Unplanned repeat laparotomies are a significant concern in surgical gastroenterology.
- Complications from initial procedures often necessitate these 'redo' operations.
Purpose of the Study:
- To investigate the reasons for redo laparotomies in a specific department.
- To analyze the outcomes and mortality rates associated with these repeat surgeries.
Main Methods:
- Retrospective analysis of 6530 patients operated between September 1996 and December 2010.
- Identification of 257 redo laparotomies performed in 193 patients.
- Data collection on patient demographics, index surgery details, reasons for re-exploration, and outcomes.
Main Results:
- Postoperative bleeding (34.2%) and abscess/fluid collection requiring drainage (29.6%) were the most frequent causes for re-exploration.
- The mortality rate following redo laparotomies was high at 33.2%.
- Sepsis and multi-organ failure were the leading causes of death.
Conclusions:
- Urgent redo laparotomies following complex abdominal operations are associated with high mortality.
- Key predictors of mortality include multiple redo laparotomies and pre-existing co-morbid conditions.
