POSTOPERATIVE COMPLICATIONS IN EMERGENCY VERSUS ELECTIVE LAPAROTOMIES AT A PERIPHERAL HOSPITAL
AbstractBackground: Laparotomy is a commonly performed procedure in any surgical unit. Postoperativecomplications directly affect the outcome of the disease. The aim of the study was to evaluate andcompare the postoperative complications in emergency versus elective laparotomies at aperipheral hospital. Methods: This comparative cross-sectional study was carried out at theDepartment of General Surgery, Combined Military Hospital, Bahawal Nagar Cantonment fromFeb 2006 to May 2009. One hundred and four consecutive patients undergoing laparotomy wereincluded. They were divided into two groups: emergency laparotomies (Group-A) and electivelaparotomies (Group-B). They were followed up meticulously and the postoperativecomplications/sequel were recorded. Results: In Group-A there were 83 patients while in GroupB only 21 patients were recorded. A total of 73 postoperative complications were seen in 28patients (33.7%) in Group-A, while 5 complications were seen in 3 patients (14.2%) in Group-B.The Group-A showed 21.6% postoperative fever and wound infection, postoperative nausea andvomiting was 13.2%, wound dehiscence 4.8%, incisional hernia 3.6%, pneumonia/anastomoticdisruption 2.4% and duodenal fistula/peristomal excoriation/adhesive intestinal obstruction 1.2%.The septicaemia was seen in 6.0% and mortality in 8.4%. Group B showed 14.2% postoperativefever and 4.7% postoperative nausea and vomiting/wound infection. No case of septicaemia ormortality was seen. Conclusion: The postoperative complications are more common inemergency laparotomies as compared to the elective ones. Postoperative fever, wound infection,nausea and vomiting are the mostly encountered complications.Keywords: Laparotomy, emergency, elective, postoperative, complications
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