Incidence and causes of relaparotomy after an obstetric and gynaecological operation
DOI:
https://doi.org/10.18203/2349-2902.isj20160247Keywords:
Relaparotomy, Primary obstetric surgery, Primary gynecological surgeryAbstract
Background: The causes for a reoperation include abdominal haemorrhage, internal bleeding, postpartum haemorrhage, rectus sheath hematoma, sepsis etc. This study was conducted to identify the cause for reoperations in our area.
Methods: This retrospective study was undertaken over a Two Years period in our hospital on 1982 patients underwent primary obstetric and gynecological surgeries out of which 15 required a resurgery. 21 cases were referred to our hospital from outside. Detailed history of the women, parity, age, clinical history, procedure of the previous surgery, hospital stay, details of any complications and discharge summary were considered. Indications of relaparotomy were also analyzed.
Results: The incidence of a relaparotomy of the surgeries performed at our hospital was 0.76%. The most common age group was 20-35 years. The most common indication for resurgery was intra peritoneal hemorrhage which accounted for 20 (55.6%) of the cases followed by rectus sheath hematoma in 9 (25%) and sepsis (11.1%). Drainage and suturing was the most common procedure performed during the relaparotomy. 5 cases underwent complete hysterectomy.
Conclusions: Relaparotomy is a rare condition which is required in 7 out of 1000 primary surgeries. Care, if taken to maintain homeostasis during the primary surgery, may reduce the need for a resurgery.
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References
Kirk RM. Reoperative surgery for early complications following abdominal and abdominothoracic operations. J R Soc Med. 1988;81:7-9.
Gunther K, Taubert E, Mehwald J. Disordered postoperative course. A retrospective analysis. Zentralbl Chir. 1988;113:384-90.
Unalp HR, Kamer E, Kar H. Urgent abdominal re-explorations. World J Emerg Surg. 2006;1:10. Available from http://www.wjes.org/content/1/1/10
Seal SL, Kamilya G, Bhattacharyya SK. Relaparotomy after cesarean delivery: experience from an Indian teaching hospital. J Obstet Gynaecol Res. 2007;33:804-9.
Wain MO, Sykes PA. Emergency abdominal re- exploration in a district general hospital. Ann R Coll Surg Engl. 1987;69:169-74.
Ashton P, Beischer N, Cullen J. Return to theatre experience at the Mercy Maternity Hospital, Melbourne 1971-1982. Aust N Z J Obstet Gynaecol. 1985;25:159-69.
Unalp H, Kamer E, Onal M. Analysis of early relaparotomy after lower gastrointestinal system surgery. Surg Today. 2008;38:323-8.
Ashton P, Beischer N, Cullen J. Return to theatre- - experience at the Mercy Maternity Hospital, Melbourne 1971-1982. Aust N Z J Obstet Gynaecol. 1985;25:159-69.
Ganchev G, Baev S, Milushev G. Relaparotomy in early postoperative complications in the abdominal cavity. Probl Khig. 1980;8:111-20.
Erdal SM, Abdulkadir T, Sıddık EM, Ender SH, Ali O, Sibel S, et al. Relaparotomy after initial surgery in obstetric and gynecologic operations: analysis of 113 cases. Ginekol Pol. 2012;83:429-32.
Martínez-Casas I, Sancho J, Nve E. Preoperative risk factors for mortality after relaparotomy: analysis of 254 patients. Langenbecks Arch Surg. 2010;395:527-34.
Zutshi V, Mehta S, Kochhar PK. Re-operative gynecologic surgeries- a 5 year retrospective study. IJGO India. 2007;10:30-3.
Tera H, Aberg C. Relaparotomy: a ten years series. Acts Chir Scand. 1975;141:637-44.
Fazari AB, Eldeen NS, Mohammed W, Muror M, Gailii E. Re-Laparotomy after Caesarean Section at Omdurman Maternity Hospital-Khartoum, Sudan. Open Journal of Obstetrics and Gynecology. 2015;5,448-54.
Dagupta S, Pratim SP, Ardhana K, Partha M, Karti M. Early Re-Operations after Gynaecological and Obstetrical Surgery—A Five Years. The Journal of Obstetrics and Gynecology of India. 2010;60:507-10.
Seffah JD. Re-Laparotomy after Caesarean Section. International Journal of Gynaecology and Obstetrics. 2005;88:253-7.
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