Abstract

LOMBARDO VAILLANT, Tomás Ariel; FERNANDEZ EXPOSITO, Wilfredo  and  CASAMAYOR JAIME, Zuleika. Reinterventions in patients with intraabdominal infection. Rev Cub Med Mil [online]. 2008, vol.37, n.4, pp. 0-0. ISSN 1561-3046.

OBJECTIVE: To analyze the surgical strategy in patients relaparotomized for presenting residual, recurrent or postoperative intrabdominal infection.. METHODS: A descriptive, cross-sectional and retrospective study was conducted among 2 997 laparotomized patients, 81 of them relaparotomized, at "Dr. Luís Díaz Soto" Higher Institute of Military Medicine from January 1994 to January 1997. The studied variables included type of surgery, reintervention window, mortality and surgical strategy. Absolute and relative values, measures of central trend and dispersion were obtained. Chi² statistical significance test (95 % of reliability, a = 0.05 ), CI of 95 %, and test of typified and corrected residues were applied. RESULTS:The reintervention rate was 2.7 % (n = 81). The relaparotomies on demand were performed in 80.2 % (n=65) , and the scheduled in 16 % (n =13). The average of the relaparotomies on demand plan was of 1.9 (1.7), whereas in the scheduled it was 3.0 (2.7). Critical time window (4-6 days) was significant as regards mortality (x² = 8.4069; p = 0.0383). Generalized peritonitis and dehiscence of the anastomotic suture showed a mortality higher than the expected (x² = 10.9538; p = 0.0271). CONCLUSIONS: Relaparotomy on demand is a proper procedure for peritonitis of moderate intensity, whereas the scheduled procedure is adequate for patients with severe peritonitis and uncertain intestinal viability. The first postoperative week had the highest incidence on adverse events and required more surveillance.

Keywords : Secondary bacterial peritonitis; reintervention; relaparotomy on demand; scheduled relaparotomy.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )