A one year study of relaparatomies at the University Teaching Hospital, Lusaka

Abstract

A Prospective Study Of Relaparotomies At The University Teaching Hospital (UTH), Lusaka was carried out over a period of one year ( 1^* may 2005 to 30*'' April 2006). It was aimed to establish the profile of patients undergoing relaparotomy at UTH. The study also looked at the after monitoring and related assessment and preparations and the short term outcome of relaparotomies. The inclusion criteria were all Patients undergoing relaparotomy whose indication was a complication of the first laparotomy. These were all from the general surgical units only. Planned relaparatomy e.g. removal of haemostatic pack and patients where the first laparotomy was done more than six weeks earlier were excluded from the study. The details of each patient were collected and entered on an evaluation form designed for the study. The information collected included name, age of the patient, file number, evolution of disease, physical examination, results of investigations, indication of first laparotomy, procedure, operative findings, indication for relaparotomy and outcome of surgery. Each patient was followed up for at least six weeks after relaparotomy except for those who died in less than six weeks. There were 276 laparotomies during the period of the study and 9% (25) of these were relaparotomies. 60% of relaparotomies were due to anastomotic leaks. There was no anastomotic leak that had a relaparatomy earlier than 7 days. There was 40% mortality on relaparotomies, 67% of which were secondary to Anastomotic leaks. There was a lot of standardization in the approach to patients. This includes the making of the diagnosis, resuscitative measures and the rush to operate immediately. Patients undergoing relaparotomy must therefore be adequately prepared with full investigations done. Given limited investigative facilities, the decision to go back should be as soon as suspicions are raised of complications based on clinical findings.