Publication:

Observational clinical study of indications and outcome of re-exploration laparotomy in 50 patients

Background Abdominal surgery that has to be re-done in association with initial surgery (Index surgery), within 60 days of initial surgery, is referred to as re-laparotomy. Redolaparotomies are called, on demand, if laparotomy has to be re-done because of patient condition and planned, if the second laparotomy is decided upon during the course of first surgery itself. Re-laparotomy is associated with increased morbidity and mortality. To find out incidence, indications, morbidity and mortality of re-laparotomy.

Methods This is a retrospective observational study of 50 cases of re-exploratory laparotomy from 2018 to 2020 done at tertiary care teaching hospital of South Gujarat.

Results In this study, majority of cases (56%) were seen in the 21-50 age group; males (37) more than females (13) with 3:1 ratio. Index operation was done in emergency in 78% (n=39) and planned in 22% (n=11) of patients. In our study mean duration between 2 laparotomies was 8 days with range of 3-20 days. It is also observed that mean duration of hospital stay among the discharged patients is 30 days with range of 15-60 days. In this study, mortality was 16% (n=8), out of which 5 patients were having co-morbidity. Out of 50 patients 34 (68%) developed local or systemic post-operative complications.

Conclusions The need for re-laparotomy supersedes risks of severe morbidities and high mortality in view of worsening clinical status of the patient.