Rabia Urooj, Shamim Qureshi, Umer Baloch, Mumtaz Maher.
Morbidity and mortality following re-laparotomy on demand.
J Surg Pak Jan ;14(3):112-5.

Objective: To evaluate the outcome in terms of morbidity and mortality after re-laparotomy on demand in patients with secondary peritonitis. Study design Descriptive study. Place & duration of study: Department of Surgery Jinnah Postgraduate Medical Center (JPMC) Karachi, from February 2006-February 2007. Patients and Methods: All those patients who presented through OPD / emergency or admitted in surgical wards of JPMC and underwent re-laparotomy on demand were included in the study. Results: A total 30 patients were included in the study with male to female ratio of 1:1.3. Mean age of patient population was 31.37 years. Most common indication of re-laparotomy was intra abdominal abscess in 63%. Most common complication encountered was wound infection in 90%.Variables which adversely affected the outcome were APACHE II score =15, time interval between index surgery and re-laparotomy of more than one week, multiple re- laparotomies, existence of sepsis and multi-organ dysfunction syndrome. About 40% patients died. Conclusion: Re-laparotomy on demand is a useful procedure to eradicate persistent or recurrent infection associated with reasonable morbidity and mortality provided if undertaken at right time with the decision being taken after close and meticulous surveillance.

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