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Indian Journal of Surgery

, Volume 81, Issue 4, pp 354–359 | Cite as

Relaparotomy—the Surgeons Nightmare

  • Anantha Krishna M A
  • Sushanth ShivaramegowdaEmail author
  • Arun Kumar M A
  • Shreyamsa Manjunath
Original Article
  • 45 Downloads

Abstract

The term relaparotomy (RL) refers to operations performed within 60 days of an initial laparotomy, for complications arising following the primary surgery. Our study aims to determine the incidence, indications, and outcome of RLs and identify factors affecting outcomes of RLs in Indian population. A prospective nonrandomized observational study was conducted at a tertiary care Medical College Hospital. Planned elective RL, those undergoing index laparotomy in other hospital were excluded. Demographic features, nutritional status, initial diagnoses, elective/emergency initial surgery, postoperative complications leading to RL, presence of diffuse peritonitis, average interval to RL, associated co morbidity, duration of hospital stay, outcome, and factors associated with outcome of RL were analyzed. Of 622 laparotomies in the study period, 30 underwent RL with incidence of 4.8%. The mean age was 52.2 years. RL was more common in emergency surgeries (80% vs 20%). The mean hospital stay among patients undergoing RL was 25.8 days. The mean interval between first laparotomy and RL was 12.3 days and the average gap between the time of detection of the complication and RL was 3.96 days. The mortality rate in the study was 20%. Five of the six mortality patients had underwent emergency primary surgery. The mean serum albumin level was 3.4 g/dL while that associated with mortality was 3.01 g/dL. All laparotomies have potential for RL. RL is associated with high morbidity and mortality. Careful surgical techniques and patient optimization help reduce RL rate. Intensive postoperative monitoring and early RL when indicated reduce mortality associated with RL.

Keywords

Relaparotomy Index laparotomy Postoperative complications Wound dehiscence Post-operative hemorrhage Re-exploration 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Association of Surgeons of India 2018

Authors and Affiliations

  1. 1.Rajarajeshwari Medical CollegeBangaloreIndia

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