Effect of Early Surgery on Outcome In Perforation Peritonitis

Abstract

BACKGROUND: Early diagnosis and emergent surgical management of perforation peritonitis remain the mainstay of treatment. The aim of study was to find the effect of early surgery on postoperative outcome in patients with perforation peritonitis.MATERIALS & METHODS: A retrospective medical report of 200 patients who underwent exploratory laparotomy and proceed for perforation peritonitis from July 2015 to December 2016 was studied. Patients were divided into two groups based on the time of surgery i.e: Early (<6 hours) and late (≥6 hours) intervention groups. All perioperative outcome of surgery were analyzed.RESULTS: Late intervention patients were more likely to develop complications (34.3 and 17.8%, P < 0.05) and mortality (14 and 6%, P<0.05) in comparison to early intervention patients and had significantly higher median time to resumption of normal diet (5and 2.8 days, length of hospital stay (15 and 9 days) and length of ICU stay (8 and 4 days) (P < 0.05). The time to operation (≥ 6 hours) and preoperative hypotension were independent risk factors for postoperative complications in multivariate analysis.CONCLUSION: Early surgical intervention within six hours along with broad spectrum antibiotics preceded by adequate aggressive resuscitation improves postoperative outcomes in perforation peritonitis.Journal of Universal College of Medical Sciences (2017) Vol.05 No.01 Issue 15, page: 12-16