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2013, Number 3

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Revista de Ciencias Médicas de la Habana 2013; 19 (3)

Abdominal surgical reintervention

Amador FY, López ME, Concepción QL

Language: Spanish
References: 20
Page:
PDF size: 64.56 Kb.


ABSTRACT

Introduction: intra-abdominal complications after laparotomy aggravate the patient's condition and worsens prognosis. Relaparotomy is the one that is carried out in a previously operated patient and who has presented postoperative intra-abdominal complication within thirty days.
Objective: to describe the results of surgical reinterventions.
Method: a descriptive, cross-sectional and prospective study was conducted at the Surgery Service of “Aleida Fernández Chardiet” General Teaching Hospital of Güines Municipality, Mayabeque Province from January 2008 to January 2011. The sample coincided with the universe (N=n) of 46 patients who were reintervened due to intra-abdominal surgical complications. It was analyzed the variables age, sex, number of reinterventions, time between the initial operation and relaparotomy, value of the intra-abdominal pressure as well as its relation to mortality and direct cause of death.
Results: patients were predominantly between 40 49 y.o., the most affected organ system in the initial intervention was the gastrointestinal one associated with secondary bacterial peritonitis, There was predominance of patients operated on before 48 hours and those who had two reinterventions, the majority presented intra-abdominal pressure Grade III and the most frequent cause of death was Multiple Organ Dysfunction.
Conclusions: the increase of the time between the initial intervention and the first reintervention, the increasing number of reinterventions and the uncontrolled increase in intra-abdominal pressure above normal values directly increases mortality for the consequences of Abdominal Compartment Syndrome.


REFERENCES

  1. Hennessey DB, Burke JP, Ni-Dhonochu T, Shields C, Winter DC, Mealy K. Infección del sitio quirúrgico después de la cirugía gastrointestinal. Ann Surg [Internet]. 2010 [citado 15 sep de 2012];252(2). Disponible en:http://www.intramed.net/contenidover.asp?contenidoID=67341

  2. Roumbelaki M, Kritsotakis EI, Tsioutis C, Tzilepi P, Gikas A. Surveillance of surgical site infections at a tertiary care hospital in Greece: incidence, risk factors, microbiology, and impact. Am J Infect Control [Internet]. 2008 [citado 15 sep de 2012];36(10). Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/18834729

  3. Brandt C, Hott U, Sohr D, et al. Operating room ventilation with laminar airflow shows no protective effect on the surgical site infection rate in abdominal surgery. Ann Surg [Internet]. 2008 [citado 15 sep de 2012]; 248.Disponible en:http://www.ncbi.nlm.nih.gov/pubmed/18948793

  4. Kirby JP, Mazuski JE. Prevención de la infección del sitio quirúrgico. Surg Clin North Am [Internet]. 2009 [citado 15 sep de 2012];89(2). Disponible en: http://www.intramed.net/contenidover.asp?contenidoID=60448

  5. Grubben AC, Baardwijk AA, Broering DC, Hoofwijk AG. Pathophysiology and clinical significance of the abdominal compartment syndrome. Zentralbl Chir [Internet]. 2001 [citado 15 sep de 2012];126(8). Disponible en:http://www.ncbi.nlm.nih.gov/pubmed/11519000

  6. Ming X, Rothenburger S, Nichols MM. In vivo antibacterial efficacy of PDS plus (polidioxanone with triclosan) suture. Surg Infect [Internet]. 2008 [citado 15 sep de 2012];9.Disponible en:http://online.liebertpub.com/doi/abs/10.1089/sur.2007.061

  7. Malbrain ML, De Laet I, Van Regenmortel N, Schoonheydt K, Dits H. Can the abdominal perimeter be used as an accurate estimation of intra-abdominal pressure? Crit Care Med. [Internet]. 2009 [citado 15 sep de 2012]; 37. Disponible en:http://ccforum.com/content/7/S2/P183/

  8. Cartú D, Georgescu I, Nemes R, Surlin V, Margaritescu D, Chiutu L, et al. Postoperative biliary peritonitis -diagnosis and treatment difficulties. Chirrugia (Bucur) [Internet]. mar 2006 [citado 15 sep de 2012];101(2). Disponible en:http://bvs.sld.cu/revistas/mie/vol7_2_08/mie08208.htm

  9. Rodríguez Acosta, Y. Jiménez Prendes R, Olivera Fajardo D, y col. Sépsis intraabdominal un reto presente y futuro. Rev Cub Med Int Emerg [Internet]. 2008 [citado 15 sep de 2012];7(3). Disponible en:http://bvs.sld.cu/revistas/mie/vol7_2_08/mie08208.htm

  10. Pusajo GF, Bumaschny E, Doglio GR. Postoperative Intrabdominal Sepsis. Requering reoperative value of a predictive index. Arch Surg. 1993;128: 218-222.

  11. Koperna T. Surgical management of severe secondary peritonitis. Br J Surg. [Internet]. 2000 [citado 15 sep de 2012];87(3). Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/10583280

  12. Kujath P, Eckmann C, Esnashari H, Bruch HP. The value of different lavage treatment patterns in diffuse peritonitis. Zentralbl Chir. 2007 Oct; 132(5):427-32.

  13. Betancourt Cervantes, JR. Martínez Ramos, Sierra Enríquez, E. y col. Relaparotomías de urgencias: evaluación en cuatro años. Rev Cubana Med Milit [Internet]. 2003 [citado 15 sep de 2012];32(4). Disponible en:http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S013865572003000400008&l ng=es&nrm=iso&tlng=es

  14. Morales IA, Delgado A, Pérez L. Sepsis intrabdominal diseminada: análisis de 119 operados en 10 años. Rev. Cubana Cir 2009; 48(4):7- 15.Disponibleen: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034- 74932009000400009&lng=es

  15. Pomata M, Vargiu N, Martinascol L, Licheri S, Zonza C, Pisano G. Our Experiencie in the Diagnosis and treatment of diffuse Peritonitis. G Chir 2010; 23 (5): 193-8.

  16. Sosa Hernández, R. Sánchez Portela, CA. Dr. Juan C. Delgado Fernández, JC. Parámetros clínicos humorales e imaginológicos en la reintervención por sépsis intrabdominal .Rev Cubana Cir 2007; 46(3))

  17. Cheatham ML, Safcsak K. Is the evolving management of intra-abdominal hypertension and abdominal compartment syndrome improving survival? Crit Care Med. 2010;38:402– 407

  18. Bohnen J, Boulanger M, Meakins JL, McLean AP. Prognosis in generalized peritonitis. Relation to cause and risk factors. Arch Surg 2003; 118: 285-90.)

  19. Rodríguez Ramírez R, Peña Araño MJ, Blanco Mila A, González Rondón L, Puertas Álvarez JF, Goderich Lalán JM. Relaparotomía de urgencia por peritonitis Secundaria. Rev Cubana Med Mil. 1998; 14: 4-5.

  20. Decoster T, Vermassen FE, Peeters PC, Hoste EA, De Waele JJ. Abdominal decompression for intra-abdominal hypertension after simultaneous pancreas-kidney transplantation. ClinTransplant. 2010; 24(1):118–121




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