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Ünalp, Haluk Recai; Kamer, Erdinç; Kar, Haldun; Bal, Ahmet; Peşkersoy, Mustafa; Önal, Mehmet Ali

doi:10.1186/1749-7922-1-10

Cited by 40 publications

(37 citation statements)

References 7 publications

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“…Our study showed higher mortality rate (35.3%) in those patients who had anastomotic leak as an indication for the relaparotomy. This result is also similar with other literatures [ 23 , 24 ]. Among the 12 patients who had SSI only 2 of them died post relaparotomy.…”

Section: Discussionsupporting

confidence: 94%

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Outcomes of early relaparotomy in pediatric patients at Tikur Anbessa teaching hospital, Addis Ababa, Ethiopia: a five-year retrospective review

2018

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BackgroundEarly relaparotomy is defined as relaparotomy within the first 30 days following surgery. The aim of this study is to explore the indications, outcomes and factors associated with relaparotomy in our pediatric population.MethodsWe performed a retrospective study of pediatric surgical patients (< 13 yrs.) who underwent relaparotomy at Tikur Anbessa Teaching Hospital between September 1, 2011 and August 31, 2016. All children who had relaparotomy within the first 30 days of the initial surgery were included. We collected patient data including demographics, operative indication, and postoperative outcomes. Data analysis was performed using SPSS Version 23. Chi-square and Fisher’s exact tests were used to report outcomes stratified by patient characteristics. Multivariable logistic regression was used to identify patient variables associated with relaparotomy and other outcomes.ResultsIn our patient population, relaparotomy rate was 17.2%. Patient age ranged from 2 days to 12 years with mean age of 37.5 months. Male to female ratio was 1.2:1. Thirty-one (58.5%) relaparotomies were performed between the 5th and 8th postoperative days. The two most common indications for relaparotomy were postoperative intra-abdominal collection and anastomotic leak, accounting for 18 (34.0%) and 17 (32.1%) respectively. Mortality rate following relaparotomy was 26.4%. The most common cause of mortality was sepsis with multi-system organ failure (90.6%). Neonatal age was found to be the independent risk factors for death following relaparotomy, (AOR = 27.59, 95% CI [2.0–379.9]).ConclusionPrevalence of relaparotomy in pediatric patients is high (17.2%) in our patient population. Neonatal age was associated with increased mortality following relaparotomy.

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Section: Discussionsupporting

confidence: 94%

“…Furthermore, patients who had anastomotic leak as an indication for the relaparotomy had a higher mortality rate (35.3%). This result is also similar with other literature [ 23 , 24 ]. Although surgical site infection rate was high, it was not significantly associated with increased mortality.…”

Section: Discussionsupporting

confidence: 94%

Outcomes of early relaparotomy in pediatric patients at Tikur Anbessa teaching hospital, Addis Ababa, Ethiopia: a five-year retrospective review

2018

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“…OD relaparotomy has been reported to carry higher morbidity and mortality rates among its victims. We report mortality for every 4 in 10 patients who underwent relaparotomy at MNH, a finding which is higher than that from by Unalp et al from Turkey [ 10 ]. Whether OD relaparotomy would have resulted in much lower mortality rates than what we have observed here has been ruled out [ 11 ].…”

Section: Discussionmentioning

confidence: 53%

Patient's characteristics, management practices and outcome of re-laparotomies in a tertiary hospital in Tanzania

Swallow

Akoko

Lema

2020

Heliyon

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Background Relaparotomy is an important indicator of the safety and quality of laparotomy in any surgical setting. Despite this, its measure in many low- and middle-income countries is scarce, Tanzania included. Understanding its existence will help curb it and mitigate its adverse outcomes by systematic improvement strategies. This study, therefore, aimed to examine characteristics of patients undergoing on-demand relaparotomy and their management outcomes at a tertiary level hospital in Tanzania. Methods A cross-sectional descriptive study was carried out in the department of surgery of Muhimbili National Hospital for one year in 2017–2018. All patients (of all ages and sex) who required an on-demand relaparotomy within 60 days of their index laparotomy were identified for inclusion into the study. Data were collected regarding patient's demography, clinical characteristics, index surgical procedure, indication for relaparotomy, number of re-laparotomies, complications during re-laparotomy, ICU admission, and mortality. Data were entered into SPSS version 23 for analysis where continuous variables were summarized as means with standard deviations and categorical variables summarized as the frequency with proportions. Ethical approval for the audit was obtained from the Muhimbili University of Health IRB. Results A total of 101 patients had undergone relaparotomy, with a relaparotomy rate among those primarily operated at our hospital of 7.6%. Their mean age was 37 years with equal sex distribution. The leading primary procedure had involved bowel resection and anastomosis (47.5%) with anastomotic leak being the leading reason for relaparotomy (37.6%) followed by intra-abdominal collection (29.7%), bowel fistula (19.8%) and wound dehiscence (18.8%). Electrolyte imbalance was the leading complication among the patients (22.9%) followed by anemia (21.5%), wound infection (18.9%) and Septicemia (11%). The overall mortality of rate was 39.6%. Conclusion On-demand relaparotomy carries a high mortality and morbidity at Muhimbili National Hospital in Tanzania. Addressing predictors and improving post-operative services are urgently needed.

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“…Thus, it is imperative to do everything possible to minimize the chance of complications. However, in the case of fatal complications, the prompt diagnosis of complications and emergency intervention via reoperation may prevent the increased risk and even save lives [ 2 ]. Therefore, emergency reoperations following complicated surgeries are known as “final-choice operations” [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Risk factors of emergency reoperations

et al. 2020

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Background: Emergency reoperation is considered to be a quality indicator in surgery. We analyzed the risk factors for emergency reoperations. Methods: Patients who underwent emergency operations from January 1, 2017, to December 31, 2017, at our hospital were reviewed in this retrospective study. Multivariate logistic regression was performed for the perioperative risk factors for emergency reoperation.Results: A total of 1,481 patients underwent emergency operations during the study period. Among them, 79 patients received emergency reoperations. The variables related to emergency reoperation included surgeries involving intracranial and intraoral lesions, highest mean arterial pressure ≥ 110 mmHg, highest heart rate ≥ 100 /min, anemia, duration of operation ＞120 min, and arrival from the intensive care unit (ICU). Conclusions: The type of surgery, hemodynamics, hemoglobin values, the duration of surgery, and arrival from ICU were associated with emergency reoperations.

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Cited by 40 publications

References 7 publications

Outcomes of early relaparotomy in pediatric patients at Tikur Anbessa teaching hospital, Addis Ababa, Ethiopia: a five-year retrospective review

Outcomes of early relaparotomy in pediatric patients at Tikur Anbessa teaching hospital, Addis Ababa, Ethiopia: a five-year retrospective review

Patient's characteristics, management practices and outcome of re-laparotomies in a tertiary hospital in Tanzania

Risk factors of emergency reoperations

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