[Psychological, moral-ethic and deontologic aspects of relaparotomy]

Analysis of the results of relaparotomy in 208 patients is presented. Psychological, moral, ethic and deontologic aspects of repeated laparotomy have been studied. In indications for relaparotomy the choice of the surgeon is advisable to make as a collective decision, on individual basis, after careful analysis of the causes of postoperative complications and with regard for the wish of the surgeon who performed the first operation. In 137 patients of 208 relaparotomy was carried out by the surgeon by whom the first operation was performed, with the assistance of more experienced surgeons. Lethality made up 35% (48 patients died after the operation). 60 patients were reoperated by the other surgeons with the assistance of the surgeon who had carried out primary operation. In 11 cases relaporotomy was carried out without participation of the surgeon who had performed the initial laparotomy. 24 (33.8%) patients died after relaparotomy performed by the other surgeons. "Radical" relaparotomies were carried out in 141 patients, in 94 (66.7%) of them being performed by the surgeon who had done the initial operation and in 47 (33.3%)--by the other surgeons. 25 (17.7%) patients died after "radical" relaparotomies and after "palliative"--47 (70.1%) patients. Total lethality after relaparotomy made up 34.6%.