Short-term outcomes of laparotomy in the two teaching hospitals of gulu university, northern uganda

Abstract

Purpose: The purpose of this study was to examine the clinical indication for laparotomy, the intra-operative findings and the 30 days post-operative outcome of laparotomy in Gulu university teaching hospitals. Methods: Using an approved protocol, a six month descriptive longitudinal study was conducted on patients undergoing laparotomy in the two main Gulu University teaching hospitals of St. Mary’s Hospital Lacor and Gulu regional referral. Using a sample size of 66, cases were recruited consecutively, clerked, investigated and conventionally prepared for surgery. Intra-operative diagnosis was ascertained as well as the operative procedure and post-operatively the patients were followed up for 30 days complications including death. Results: Overall, the mean age was 35.04yrs (SD+/- 16.522), but there were more males (59.4%) than females (40.6%). There was a statistically significant positive correlation between the clinical diagnosis and the intraoperative findings (r = 0.405, P value = 0.001). Within the 30days, the most frequent complication observed was surgical site infection (SSI) (20%, n=13), followed by wound dehiscence (17.2%, n=11), crude mortality rate was 15.6%, (n=10) and complication requiring emergency re-operation (10.9%, n=7). Ileal perforations tended to have bad outcomes. Age of patient was found to be a significant factor in determining the outcome. Conclusion: Descriptive longitudinal study on both elective and emergency laparotomy is possible in our setting. Whereas patients’ age is an important factors in determining outcome and ileal perforation tend to do better if prioritized with ileostomy, overall the 30days mortality rate for laparotomy was 15.6%.