2008
DOI: 10.1159/000158911
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Decision Making for Relaparotomy in Secondary Peritonitis

Abstract: Background/Aims: To provide a qualitative ranking of clinical variables by surgeons that influence their decision for reoperation and to evaluate whether these variables are related to positive findings at relaparotomy. Methods: Importance in decision making for relaparotomy was evaluated for 21 factors using a 10-point visual analogue scale (VAS). Variables with median VAS scores >5.0 were labeled ‘important’. Predictive value for positive findings was evaluated by multivariate analysis. Results: The response… Show more

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Cited by 24 publications
(22 citation statements)
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“…Several studies over the last decade have also failed to identify clear risk factors or surrogates for persistent peritonitis [4,25,26] . The time to reoperation varies considerably according to the literature, from 2 to 7 days [4,16,27], but some papers have reported delayed reoperations after up to 20 days [16] .…”
Section: Discussionmentioning
confidence: 99%
“…Several studies over the last decade have also failed to identify clear risk factors or surrogates for persistent peritonitis [4,25,26] . The time to reoperation varies considerably according to the literature, from 2 to 7 days [4,16,27], but some papers have reported delayed reoperations after up to 20 days [16] .…”
Section: Discussionmentioning
confidence: 99%
“…In these cases, single operation may not be sufficient to achieve source control; thus, relaparotomy may become necessary [113, 114]. In 2007, van Ruler and the Dutch peritonitis group [115] published a randomized, clinical trial addressing two aspects of closed abdominal management, comparing an on-demand versus planned relaparotomy strategy in patients with severe peritonitis who had the fascia formally closed after the initial laparotomy.…”
Section: Which Is the Best Relaparotomy Strategy?mentioning
confidence: 99%
“…Van Ruler et al [92] in 2008 reported the results of a questionnaire asking surgeons to rank the importance of 21 clinical variables on their decision to re-operate in patients with secondary peritonitis. They found that diffuse extent of the abdominal contamination, localization of the infectious focus (upper gastrointestinal tract including small bowel), and both, extremely low and high leukocyte counts, independently predicted a re-laparotomy.…”
Section: Source Controlmentioning
confidence: 99%