POST-OPERATIVE COMPLICATIONS FREQUENCY IN PATIENTS UNDERGOING EMERGENCY LAPAROTOMY IN TERTIARY CARE HOSPITAL
DOI:
https://doi.org/10.54112/bcsrj.v2024i1.1464Abstract
One of the most frequent surgical procedures performed by general surgeons is laparotomy. Early diagnosis and prompt treatment of postoperative complications are the goals of appropriate post-operative care. Objective: The study aimed to explore Post-operative complications frequency in individuals undergoing emergency laparotomy in tertiary care hospitals. Methods: This hospital-based, single-centre longitudinal prospective observational study was carried out at the Surgical Unit 2 SIMS/ Services Hospital Lahore from January 2022 to January 2024 after getting permission from the ethical board. A total of 254 participants in the general surgical unit for emergency laparotomies were included. A thorough medical history of each individual was collected. Participants were followed for post-operative issues and mortality with risk variables after surgery. Clavien-Dindo and severity classifications were used to categorize post-operative issues. Data was entered into Microsoft Excel and presented in the form of tables and figures. Results: A total of 254 individuals took part in this study out of which male were 57(22.44%) and female were 197(77.55 %.). The most prevalent age group in the study participants was 40 to 59 years group 108(42.5%). Gastrointestinal perforation accounts for 80 (31.49%) of the reasons for an exploratory laparotomy, subsequently followed by duodenal perforations 40 (15.7%), gallbladder perforation 30 (11.8%), blunt & penetrating trauma abdomen 15 (5.9%), and appendicular abscess 14 (5.5%). Surgical site infection was the most frequent of these, 120 (47%), followed by fever 97(38.1%) and pneumonia 76 (30 %), thrombophlebitis 27 (10.8%), after surgery ileus 32, (12%), UTI 25 (10%), and nausea and vomiting 35(14%). The mortality rate in our study was 7 %.Conclusion: The current study concluded that emergency laparotomies are more likely to result in postoperative complications than elective ones. The most frequent negative outcomes include fever, vomiting nausea, and postoperative surgical site infection. The overall mortality rate in our study was 7%.
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References
Bansal AR, Mallick MR and Jena S. A study of postoperative complications of all emergency laparotomy in a tertiary care hospital within 90 days. Arch Clin Gastroenterol. 2019; 5(2):15-18.https://doi.org/10.17352/2455-2283.000062
Murtaza B, Saeed S and Sharif MA. Postoperative complications in emergency versus elective laparotomies at a peripheral hospital. J Ayub Med Coll Abbottabad. 2010; 22(3):42-47.
Zimmerman JE, Wagner DP, Draper EA, Wright L, Alzola C and Knaus WA. Evaluation of acute physiology and chronic health evaluation iii predictions of hospital mortality in an independent database. Crit Care Med. 1998;26:1317-26.https://doi.org/10.1097/00003246-199808000-00012
Huddart S, Peden CJ, Swart M. Use of a pathway quality improvement care bundle to reduce mortality after emergency laparotomy. Br J Surg. 2015; 102(1):57-66.https://doi.org/10.1002/bjs.9658
Pearse RM, Harrison DA and James P. Identification and characterisation of the high-risk surgical population in the United Kingdom. Crit Care. 2006; 10(3):R81.https://doi.org/10.1186/cc4928
Dickson JA and Cole GJ. Perforation of the terminal ileum. A review of 38 cases. Br J Surg. 1964; 51:893-897. https://doi.org/10.1002/bjs.1800511207
Noguiera C, Silva AS, Santos JN, Silva AG, Ferreira J, Matos E, et al. Perforated factors of morbidity and mortality. World J Surg. 2003;27:782-787.https://doi.org/10.1007/s00268-003-6645-0
Kapoor S, Sharma R, Srivastava A, Kumar A, Singh A and Singh H. Study of surgical complications of explorative laparotomy and their management study of 100 cases. J Dent Med Sci. 2017; 16(12):36-41.
Gupta S, Kaushik R, Sharma R and Attri A. The management of large perforations of duodenal ulcers. BMC Surg. 2005;5:15.https://doi.org/10.1186/1471-2482-5-15
Wani RA, Bhat FQ and Bhatand MA. Nontraumatic terminal ileal perforation. World J Emerg Surg. 2006; 11:95-399.
Gandhi JA, Shinde PH and Digarse RD. Evaluation of abdominal wall closure technique in emergency laparotomies at a tertiary care hospital. Int Surg J. 2016;3:1796-1801.https://doi.org/10.18203/2349-2902.isj20162813
Jhoota RS, Attri AK, Kaushik R, Sharma R and Thobta A. Spectrum of perforation peritonitis in India-review of 504 consecutive cases. World J Emerg Surg. 2006;1:26.https://doi.org/10.1186/1749-7922-1-26
Chauhan S, Chauhan B and Sharma H. A Comparative study of postoperative complications in emergency versus elective laparotomy at a tertiary care centre. Int Surg J. 2017;4:2730-2735.https://doi.org/10.18203/10.18203/2349-2902.isj20173408
Jawaid M, Masood Z and Iqbal SA. Post-operative complications in a general surgical ward of a teaching hospital. Pak J Med Sci. 2006; 22(2):171-175.
Waqar SH, Malik ZI, Razzaq A, Abdullah MT, Shaima A and Zahid MA. Frequency and risk factors for wound dehiscence/ burst abdomen in midline laparotomies. J Ayub Med Coll Abbottabad. 2005; 17(4):70-73
Buhler L, Mentha G, Borst F, Roche B, Morel P and Rohner A. Safety of cholecystectomy by laparotomy in elective situation and in emergency. J Chir (Paris). 1992; 129(11):466-470
Afzal S and Bashir M, Determinants of wound dehiscence in abdominal surgery in Public Sector Hospital. Ann King Edward Med Univ. 2008; 14(3):110-117
Mentula PJ and Leppäniemi AK. Applicability of the ClavienDindo Classification to emergency surgical procedures: A retrospective cohort study on 444 consecutive patients. Patient Saf Surg. 2014; 8:31-37..
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