Relaparotomy—the Surgeons Nightmare

A, Anantha Krishna M; Shivaramegowda, Sushanth; A, Arun Kumar M; Shreyamsa, M

doi:10.1007/s12262-018-1823-3

Cited by 5 publications

(6 citation statements)

References 9 publications

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“…As much as 71% of all patients underwent relaparotomy due to anastomosis dehiscence and 66% from patients underwent relaparotomy due to burst abdomen were found to have hypoalbuminemia. 15 In this study, the lower the albumin level (either pre-or post-operatively), the longer hospitalization period was found. This results were in accordance with study by Hennessey et al 16 that showed hypoalbuminemia was associated significantly with longer hospitalization period compared to those with normal serum albumin levels (19.5 days vs. 12 days).…”

Section: Discussionmentioning

confidence: 48%

Impact of albumin levels on clinical outcomes in children underwent abdominal surgery

Dewi

Silitonga

Mangunatmadja

2020

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Background Patients underwent abdominal surgery and had hypoalbuminemia were at risk of post-operative complications. The prognostic role of albumin levels in children with abdominal surgery remains unclear. Objective To investigate the impact of albumin levels on clinical outcomes related to the complications in children with abdominal surgery. Methods This was a retrospective cohort study on children aged 29 days to 18 years, who underwent abdominal surgery, had serum albumin levels measured at pre-operative and within 48 hours post-operatively, and hospitalized in Paediatric Intensive Care Unit of Dr. Cipto Mangunkusumo Hospital, Indonesia. The primary outcomes were post-operative complications (sepsis, surgical site infection, shock), length of stay in PICU, dehiscence, relaparotomy, and postoperative mortality. Results This study recruited a total of 201 children. Pre- and post-operative serum albumin levels of ≤ 3.00 g/dL were found in 15.4% and 51.2%, respectively. Pre- and post-operative serum albumin levels of ≤ 3.00 g/dL were associated with higher risk of post-operative sepsis (RR 3.4; 95%CI 1.54 to 7.51) and relaparotomy (RR 3.84; 95%CI 1.28 to 1.49). The median of length of PICU stay was 4 days longer in children with pre-operative serum albumin levels ≤ 3.00 g/dL (P<0.001). Conclusions Hypoalbuminemia condition in children undergo abdominal surgery is associated with increased risk of post-operative sepsis, longer length of stay in PICU, and risk of relaparotomy.

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Section: Discussionmentioning

confidence: 48%

Impact of albumin levels on clinical outcomes in children underwent abdominal surgery

Dewi

Silitonga

Mangunatmadja

2020

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“…Of the 31 studies included in this review, 23 studies (75 per cent) provided a definition of malnutrition. This was by use of a nutrition screening tool alone 33 , 34 , 39 , 48 , 50 , an assessment tool 28 , 29 , 32 , 37 , 38 , 40–42 , 51 , or a nutrition marker, either on its own 35 , 43 , 45 or combined 5 , 31 , 44 , 49 , 52 , 53 . There were two studies that provided no definition of malnutrition 46 , 54 .…”

Section: Resultsmentioning

confidence: 99%

“…There were seven single measures used to define malnutrition ( Table 6 ): albumin, arm muscle circumference, BMI, cholinesterase, haemoglobin, neutrophil to lymphocyte ratio, and the total number of lymphocytes. Albumin 28 , 40 , 43 , 45 , 55 and BMI 28 , 35 , 40 , 54 , 57 were the most commonly used measures (used in five studies each).…”

Section: Resultsmentioning

confidence: 99%

Identifying malnutrition in emergency general surgery: systematic review

Ashmore,

Rashid,

Wilson

et al. 2023

BJS Open

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Background Emergency general surgery practice is high risk. Surgery is a key part of treatment, with resultant catabolic stress and frequent need for nutritional support. The aim of this study was to examine the current methods of defining and determining malnutrition in emergency general surgery. This included examining the use of nutrition screening and assessment tools and other measures of malnutrition. Methods MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, trial registries, and relevant journals published between January 2000 and January 2022 were searched for studies of adult patients with any emergency general surgery diagnosis, managed conservatively or operatively, with an assessment of nutritional status. Mixed populations were included if more than 50 per cent of patients were emergency general surgery patients or emergency general surgery results could be separately extracted. Studies in which patients had received nutritional support were excluded. The protocol was registered with PROSPERO, the international prospective register of systematic reviews (CRD42021285897). Results From 6700 studies screened, 324 full texts were retrieved and 31 were included in the analysis. A definition of malnutrition was provided in 23 studies (75 per cent), with nutritional status being determined by a variety of methods. A total of seven nutrition screening tools and a total of nine ‘assessment’ tools were reported. To define malnutrition, the most commonly used primary or secondary marker of nutritional status was BMI, followed by albumin level. Conclusion Wide variation exists in approaches to identify malnutrition risk in emergency general surgery patients, using a range of tools and nutrition markers. Future studies should seek to standardize nutrition screening and assessment in the emergency general surgery setting as two discrete processes. This will permit better understanding of malnutrition risk in surgical patients.

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“…This number is higher than the global relaparotomy rate (0,12%-0,72%) (Peker et al, 2019). However, it is still within the normal range compared to other studies, and relaparotomy ranged from 1-4,4% (Krisna et al, 2018) and 1-1,6% after the first surgery (Patel et al, 2017). The most common indications for first surgery were placenta accreta (3 cases), antepartum bleeding (2 cases), twice previous caesarean section (1 case), cardiac cases with Eisenmenger syndrome (1 case), and pregnancy with suspected malignant ovarian tumour (1 case).…”

Section: Discussionmentioning

confidence: 52%

Analysis of Post-Obstetric Surgery Referrals with Surgical Complications to Tertiary Hospital in Indonesia

Novitasari¹,

Dharmayanti²,

Winardi³

et al. 2021

IJRP

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Recently, the high rate of C-section is caused by obstetric indications and large number of elderly pregnant patients with maternal complications and fetal continuous monitoring use. C-section has higher risk of complication than vaginal delivery. Some post obstetric surgery complications require aggressive measures such as relaparotomy on critical conditions that cause morbidity.This retrospective study will analyze the profile of post-obstetric surgery referrals with surgical complications to Dr. Soetomo General Teaching Hospital. The records were total sampling according to inclusion and exclusion criteria using medical record data in 2019-2020.There were 27 cases of post-obstetric surgery referrals with surgical complications from all 70 post-obstetric surgery referrals (38.5%)-most referrals from outside Surabaya by private hospitals. Most patients were in 21-35 years (74%), 51.85% multiparity, only 18.5% with obesity. Most of the patients came with hypovolemic shock and complications of thrombocytopenia, prolonged haemostasis, and acute renal impairment. Most common indications for referrals are internal bleeding and postpartum hemorrhage. Operations at the referring hospital were performed emergency in 77.7% of cases. The most indications for surgery that increased the risk of relaparotomy were previous C-sections and the arrest of labors. Relaparotomy was performed in 23 cases (83.1%), most common findings were bleeding from the corner stitch of uterine incision and retroperitoneal hematoma. Most common procedures during relaparotomy were hysterectomy 42.42% and vascular ligation 30.3%.Relaparotomy on post obstetric surgery referrals was performed in patients with suspicion of internal bleeding due to bleeding from corner stitch of uterine incision and indications for surgery that were risk factors for relaparotomy were previous caesarean section and arrest of labors

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Relaparotomy—the Surgeons Nightmare

Cited by 5 publications

References 9 publications

Impact of albumin levels on clinical outcomes in children underwent abdominal surgery

Impact of albumin levels on clinical outcomes in children underwent abdominal surgery

Identifying malnutrition in emergency general surgery: systematic review

Analysis of Post-Obstetric Surgery Referrals with Surgical Complications to Tertiary Hospital in Indonesia

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