Prospective study on pattern, associated factor And outcome of laparotomy among surgical Patient at jimma university medical center from January 1,2021 - December 30, 2021, jimma, south-west Ethiopia

Abstract

Re-laparotomy defined as a re-abdominal operation performed within 60 days relate to the first surgery. In practice laparotomy and relaparotomy as thus defined are performed with few exceptions during the same stay in hospital. The most common indications for re-laparotomy are peritonitis, infection, bleeding, abscess, anastomotic leakage, wound dehiscence, necrotizing pancreatitis, bowel necrosis, bowel obstruction and evisceration. patients with re-laparotomy had high in mortality as well as exposed to the disease. It accounts about 1.5-27% of patients with abdominal surgery. The objective was to assess the pattern, associated factor and outcome of relaparotomy among all surgical patient and Cross-sectional study design was carried out at JUMC from January 1, 2021- December 30, 2021. Out of 939 patients who underwent laparotomy procedure, for 78 patient’s re laparotomy was done which gives the overall prevalence of 8.3% in our study. The leading indication for re operation was post op collection in 17 (26.6%) followed by anastomotic leak in 14(21.9%), obstruction 12 (18.8%), and dehiscence in 10(15.6%). The mean time to re laparotomy was 6.5 days. the post operative mortality rate was 20.3%. the majority of relaparotomy was done on demand base (87.5%). Mortality rates for re laparotomy following anastomotic leak was found to be high (40%), while mortality due to wound dehiscence and obstruction (16.7%) have been low. Intra-abdominal collection and anastomotic leak were the most common indications of re-laparotomies. Anastomotic leaks were significantly associated with mortality.