Background: Many laparotomy may require relaparotomy due to post-operative complication as life-saving procedure. Incidence of relaparotomy and post-operative outcome defers from patient to patient. The objectives of our study were to evaluate the indication of relaparotomy, outcome of the relaparotomy and factors affecting mortality.Methods: Data was collected between March 2017 and November 2019 in SSG hospital, Vadodara. Patient’s demographics, indication and intra-operative findings of initial surgery and relaparotomy with morbidity and mortality were studied. Patients from department general surgery and obstetrics and gynecology were included. Consent was taken in a pre-validated form.Results: Out of total 5684 laparotomy performed, 146 (2.58%) patients underwent relaparotomy. Male to female ratio was 1.5:1. Incidence was highest in 31-40 years age group (median age: 37 years). Dirty wound in initial laparotomy had highest conversion rate (3.21%) to relaparotomy. Mean interval between initial laparotomy and relaparotomy was 8.57±5.62 days. The major indication of relaparotomy was burst abdomen (39.52%) followed by leak from previously sutured site (24.65%). 50.68% patients were shifted to ICU following relaparotomy. Average days of ICU admission were 4.16±2.25 days. Mortality rate was 23.29%. Maximum mortality was noted in case of leak from anastomotic or perforation site. 14 (38.88%) deaths occurred during postoperative day second to fourth with mean hospital stay of 21.85±8.65 days.Conclusions: Although relaparotomy is life-saving procedure, it has high mortality rate. The possibility of efficiently lowering relaparotomy depends on success of the first laparotomy, patient’s status, early re-exploration with proper surgical techniques and thorough postoperative care.

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Background: There are several methods of circumcision with its own merits and demerits. Dorsal slit technique is practised all over the world most commonly. The sleeve technique introduced later on which helps in preventing common complications of open technique. Aim: To compare complications of sleeve technique versus conventional dorsal slit technique for circumcision in children. Material and Methods: Total 64 patients were studied by doing comparison of complications between sleeve technique and dorsal slit technique of circumcision allocated randomly. Post-operative pain was evaluated by Visual Analogue Scale (VAS) at 1, 3, 6 and 24 hour. Blood loss, healing time were assessed. Patient was examined on follow up at 1, 2 and 6 week. Results: For Dorsal slit technique, the mean of gauze pieces used was 2.12 pieces and for sleeve technique, the mean of gauze pieces used was 1.71 pieces. For Dorsal slit technique, the mean VAS score was 2.90 and for sleeve technique, the mean VAS score was 2.40. For dorsal slit technique, the mean of healing time was 16 days and for sleeve technique, the mean of healing time was 15.43 days. Post-operatively, 14 and 9 patients of dorsal slit technique and sleeve technique had edema at local site, respectively. Conclusion: Sleeve technique produces a good postoperative result, less bleeding and less postoperative pain as compared to dorsal slit technique. Hence, sleeve technique is recommended for circumcision as compared to dorsal slit technique.

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