A large number of patients undergo various operative procedures every day and laparotomy forms a large proportion. At times, laparotomies have to be redone due to complications like biliary peritonitis, faecal fistula, burst abdomen or anastomotic leak. Our objectives were to determine the causes of Redo-laparotomy evaluate morbidity associated with it and analyze its outcome. A prospective study of patients in BP Koirala Institute of Health Sciences (BPKIHS) from 1. 1. 2009 to 31. 12. 2009 was done. Institutional ethical clearance was taken. The Statistical analyses were done using SPSS version 11.5. Redo-laparotomy was performed in 40(1.99%) cases. The mean age was 31.99 +/- 21.49 years with a M: F ratio of 4:3. The indications of Redo-laparotomy were: burst abdomen (n = 9; 22.5%), followed by intra-abdominal collection and abscess (n = 7; 17.5%), fecal (n = 6; 15%), and biliary peritonitis (n = 5; 12.5%). The mean duration between first laparotomy and Redo was 9.42 +/- 7.56 days and the mean duration of hospitalization was 26.98 +/- 12.50 days. Lower gastrointestinal surgeries usually lead to a Redo. The mortality in our study was 30% and 21/40 patients had to be managed in the intensive care unit. Clinical acumen formed the basis (87.5%) to decide for Redo-laparotomy in the majority. Redo-laparotomies that are performed following complicated abdominal surgeries have high morbidity and mortality rates. Multiple factors may lead to a Redo-laparotomy which is beyond the hands of a clinician yet a vigilant and vigorous management could help reduce the rate of Redo-laparotomies.
Download full-text PDF |
Source |
---|
BMC Surg
January 2025
Department of Gastroenterological Surgery, Division of Inflammatory Bowel Disease, Hyogo Medical University, 1-1, Mukogawacho, Nishinomiya, Hyogo, Japan.
Background: Surgical site infections (SSIs) can affect mortality, morbidity, and medical costs. Although it has recently been reported that washing with antiseptic/antibiotic solution can prevent SSI in clean surgery, the clinical impact in gastrointestinal surgery is still uncertain. Therefore, we performed a systematic review and meta-analysis to evaluate the efficacy of antiseptic/antibiotic solution during wound irrigation or peritoneal lavage in gastroenterological surgery.
View Article and Find Full Text PDFJ Gastrointest Surg
January 2025
Division of Surgical Oncology, Department of Surgery, Yale University School of Medicine, New Haven, CT, United States. Electronic address:
Background: Despite efforts to expand insurance coverage, substantial inequalities persist, particularly in cancer treatment. This study aimed to evaluate whether quality disparities exist across major insurance plans for patients undergoing curative-intent resection for gastrointestinal (GI) cancers.
Methods: This was a retrospective study of adult patients in the National Cancer Database diagnosed with GI malignant neoplasms between January 1, 2004, and December 31, 2020.
Cancer Med
January 2025
Department of Tumor Biology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.
Background: Metastatic colorectal cancer (mCRC) is the main cause of CRC mortality, with limited treatment options. Although immunotherapy has benefited some cancer patients, mCRC typically lacks the molecular features that respond to this treatment. However, recent studies indicate that the immune microenvironment of mCRC may be modified to enhance the effect of immune checkpoint inhibitors.
View Article and Find Full Text PDFGeorgian Med News
October 2024
3State Higher Medical College named after D. Kalmataev, Semey, Republic of Kazakhstan.
Purpose Of The Study: improving the surgical treatment of biliary pancreatitis by using a universal retractor and improved methods of omentobursostomy with drainage of the omental bursa.
Study Design: Non-randomized controlled clinical trial Material and methods: This study included thirty-nine patients who underwent surgical procedures between October 2022 and September 2023 in Semey, located in the Abay region. The study examined the general characteristics of surgical interventions performed for acute biliary pancreatitis using our proposed treatment methods and devices to improve the outcomes of acute biliary pancreatitis.
Surg Endosc
December 2024
Department of Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, USA.
Background: There are few reported outcomes of treatment of acute cholecystitis incorporating current guidelines for gallbladder dissection techniques and use of percutaneous tube cholecystostomy (PCT). The authors hypothesize PCT allows regression of peritoneal inflammation, but infundibular inflammation is increased at interval cholecystectomy, resulting in greater requirement for advanced dissection techniques.
Methods: Between December 2009 and July 2023, 1222 patients were admitted with acute cholecystitis and ultimately underwent cholecystectomy.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!