Clinical study of relaparotomy after emergency general surgery in a tertiary center of central India: a retrospective study

Abstract

Background: Relaparotomy after emergency surgery is a catastrophic situation associated with significant morbidity and mortality. Incidence is highly variable depending not only on hospital set up but also on the patient’s characteristics as well as on the initial surgery and postoperative care given. This study was thus, planned to identify the indications, procedure, risk factors and outcomes of relaparotomy so that timely intervention can lower incidence and morbidity.Methods: This was a retrospective cohort study conducted in department of general surgery, Gandhi Medical College and associated Hamidia Hospital from January 2018 to December 2019. All patients irrespective of age and sex, who have undergone emergency re-exploration of the abdomen during the period of hospitalization after the first operation and discharge of patients. Data were recorded in pre-validated case record form.Results: 32 cases of relaparotomy were identified. All patients had emergency laparotomy as primary surgery. Majority of patients required relaparotomy for anastomotic site leak in 16 cases (50%) followed by intestinal obstruction in 10 cases (31%), hemorrhage in 4 cases (16%) while the least cause being intra-abdominal sepsis in 2 cases (6.2%). Relaparotomy was associated with increased mortality and morbidity. Out of 32 patients, 4 (12.5%) patients died.Conclusions: Relaparotomy is a rare complication and a lifesaving procedure for patients. Calculative experience guided decision on relaparotomy can decrease the incidence of morbidity and mortality associated with the procedure.