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World Journal of Emergency Surgery

, 1:10

First Online: 04 April 2006Received: 18 February 2006Accepted: 04 April 2006

Abstract

BackgroundTreatment of a number of complications that occur after abdominal surgeries may require that Urgent Abdominal Re-explorations UARs, the life-saving and obligatory operations, are performed. The objectives of this study were to evaluate the reasons for performing UARs, outcomes of relaparotomies RLs and factors that affect mortality.

MethodsDemographic characteristics; initial diagnoses; information from and complications of the first surgery received; durations and outcomes of UARs performed in patients who received early RLs because of complicated abdominal surgeries in our clinic between 01.01.2000 and 31.12.2004 were investigated retrospectively. Statistical analyses were done using the chi-square and Fisher exact tests.

ResultsEarly UAR was performed in 81 out of 4410 cases 1.8%. Average patient age was 50.46 13–81 years with a male-to-female ratio of 60-21. Fifty one 62.96% patients had infection, 41 50.61% of them had an accompanying serious disease, 24 29.62% of them had various tumors and 57 70.37% patients were operated under emergency conditions during first operation. Causes of urgent abdominal re-explorations were as follows: leakage from intestinal repair site or from anostomosis n:34; 41.97%; hemorrhage n:15; 18.51%; intestinal perforation n:8; 9.87%; intraabdominal infection or abscess n:8; 9.87%; progressive intestinal necrosis n:7; 8.64%; stomal complications n:5; 6.17%; and postoperative ileus n:4; 4.93%. Two or more UARs were performed in 18 22.22% cases, and overall mortality was 34.97% n:30. Interval between the first laparotomy and UAR averaged as 6.95 1–20 days, and average hospitalization period was 27.1 3–78 days.

Mortality rate was found to be higher among the patients who received multiple UARs. The most common 55.5% cause of mortality was sepsis-multiple organ failure MOF. The rates for common mortality and sepsis-MOF-dependent mortality that occured following UAR were significantly higher in patients who received GIS surgery than in those who received other types of surgeries p:0.000 and 0.010, respectively.

ConclusionUARs that are performed following complicated abdominal surgeries have high mortality rates. In particular, UARs have higher mortality rates following GIS surgeries or when infectious complications occur. The possibility of efficiently lowering these high rates depends on the success of the first operations that the patient had received.

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Autor: Haluk Recai Unalp - Erdinc Kamer - Haldun Kar - Ahmet Bal - Mustafa Peskersoy - Mehmet Ali Onal

Fuente: https://link.springer.com/







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