TY - JOUR
T1 - Planned re-laparotomy in a non-trauma setting
T2 - A single center experience
AU - Hershkovitz, Yehuda
AU - Ashkenazi, Itamar
AU - Shapira, Zahar
AU - Zmora, Oded
AU - Jeroukhimov, Igor
N1 - Publisher Copyright:
© 2018, Israel Medical Association. All rights reserved.
PY - 2018/5
Y1 - 2018/5
N2 - 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.
AB - 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.
KW - Damage control laparotomy (DCL)
KW - Planned re-laparotomy (PRL)
KW - Septic abdomen
UR - http://www.scopus.com/inward/record.url?scp=85047121787&partnerID=8YFLogxK
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C2 - 29761676
AN - SCOPUS:85047121787
SN - 1565-1088
VL - 20
SP - 300
EP - 303
JO - Israel Medical Association Journal
JF - Israel Medical Association Journal
IS - 5
ER -