Planned re-laparotomy in a non-trauma setting: A single center experience

Yehuda Hershkovitz*, Itamar Ashkenazi, Zahar Shapira, Oded Zmora, Igor Jeroukhimov

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Damage control laparotomy (DCL) is the widely accepted procedure of choice in management of severely injured trauma patient. It has been implemented in non-trauma-related surgical pathology in the last decade. Objectives: To evaluate our experience with planned relaparotomy (PRL) in non-trauma patients and compare it to other reports. Methods: Charts of all patients admitted to Assaf Harofeh Medical Center who underwent PRL for non-trauma-related abdominal pathology during a 6 year period were reviewed. Data regarding demographics, vital signs, laboratory tests, indications for surgery, length of hospital stay, and mortality were obtained from medical charts. Indications for surgery, risk factors, and mortality were analyzed. Results: The study was comprised of 181 patients. Primary abdominal sepsis (50), postoperative sepsis (49), mesenteric event (32), and intestinal obstruction (28) were the most common indications for PRL. Mortality rate was 48.6%. Factors correlating with increased mortality were advanced age, hypotension, hypothermia, metabolic acidosis, and renal failure. Bowel resection was performed on 122 patients (67%) and primary intestinal anastomosis constructed in 46.7%. Mortality rate was lower in patients who underwent PRL with primary anastomosis compared to patients with postponed bowel anastomosis (33.3% vs. 55.4%, P = 0.018). Conclusions: PRL in abdominal emergencies carries a high mortality rate. Primary anastomosis may be considered in non-trauma-related PRL.

Original languageEnglish
Pages (from-to)300-303
Number of pages4
JournalIsrael Medical Association Journal
Volume20
Issue number5
StatePublished - May 2018

Keywords

  • Damage control laparotomy (DCL)
  • Planned re-laparotomy (PRL)
  • Septic abdomen

Fingerprint

Dive into the research topics of 'Planned re-laparotomy in a non-trauma setting: A single center experience'. Together they form a unique fingerprint.

Cite this