Re-laparotomy in OBG: a clinical study

Authors

  • Bhagyashree Bijjaragi Department of Obstetrics and Gynecology, KIMS, Koppal, Karnataka, India
  • Amulya M. N. Department of Obstetrics and Gynecology, KIMS, Koppal, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20181021

Keywords:

Burst abdomen, Hemorrhage, Re-laparotomy

Abstract

Background: If laparotomy done within 60 days of primary surgery for the original disease it is called re-laparotomy. Aim of this study was to determine the risk factors causing re-laparotomy, the indications, management and outcomes of re-laparotomy.

Methods: The study was conducted in the department of Obstetrics and Gynaecology, Vijayanagar Institute of Medical Sciences Hospital, Bellary, Karnataka. It is a 2 year prospective observational study of all the patients with re-laparotomy following operation done for obstetric or gynaecological indications.

Results: Total 4105 patients underwent major surgery in two years between October 2013 to September 2015. Re-laparotomy was done in 10 cases. The incidence of re-laparotomy was 0.25% which is mainly for subacute intestinal obstruction, intraperitoneal haemorrhage, burst abdomen, PPH, rectus sheath hematoma.

Conclusions: Hemorrhage, burst abdomen, infections are the main reasons for re-laparotomy after obstetric and gynaecological surgeries. Though the incidence of re-laparotomy is low and the outcome is favourable, several measures must be undertaken to prevent re-laparotomy such as careful surgical technique, meticulous hemostasis and strict asepsis should be maintained.

References

Thombarapu U, Kodey PD, Koneru G. Retrospective study of relaparotomy in department of obstetrics, gynaecology and family planning in, rural tertiary care hospital, Andhra Pradesh, India. Int J Med Res Health Sci. 2015;4(3):582-6.

Salam R, Sabera S, Farhna D, Sama A. Relaparotomy after Caesarean Section in Tertiary Referral Teaching Hospital of Bangladesh. Bangladesh J Obstet Gynaecol. 2012;24:39.

Alam IP, Mahabuba, SR Das.Relaparotomy in Obstetrics and Gynaecology Department of Faridpur Medical College Hospital - Experience in One Year. Faridpur Med Coll J. 2012;7(2).

Khan NB, Kolasseri SS. Relaparotomy after caesarean section: an analysis of the risk factors, indications and outcome. Int J Reprod Contracept Obstet Gynecol. 2015 Jun;4(3):575-80.

Unalp HR, Kamer E, Kar H, Bal A, Peserkoy M, Onal MA. Urgent abdominal re-exploration. World J Emerg Surg. 2006;1:10.

Sak ME, Turgut A, Evsen MS, Soydinc HE, Ozler A, Sak S et al. Re-laparotomy after initial surgery in obstetric and gynecologic operations: analysis of 113 cases. Ginekol Pol. 2012;83:429-32.

Raagab AE, Mesbah YH, Brakat RI, Zayed AA, Alsaammani MA. Re-laparotomy after cesarean section: risk, indications and management options. Med Arch. 2014 Feb;68(1):41.

Levin I, Rapaport AS, Satzer L, Maslovitz S, Lessing JB, Almog B. Risk factors for relaparotomy after cesarean delivery. Int J Gynaecol Obstet. 2012 Nov; 119(2):163-5.

Seal SL, Kamilya G, Bhattacharya SK, Mukherji J, Bhattacharya AR. Relaparotomy after caesarean delivery: experience from an Indian teaching hospital. J Obstet Gynaecol Res. 2007;33(6):804-9.

Seffah JD. Re-laparotomy after Cesarean section. Int J Gynecol Obstet. 2005;88(3):253-7.

Shyamal D, Pratim SP, Aradhana K, Partha M, Kirti M, Subhankar D. Early re-operations after gynecological and obstetrical surgery-a five years. J Obstet Gynecol India. 2010 Dec;60(6):507-10.

Falcone T, Stovall G. In: Berek JS, Berek DL. Berek and Novak’s Gynecology.15th ed. New Delhi: Wolter Kluwer;2013:831.

Badejoko OO, Ijarotimi AO, Awowole IO, Loto OM, Badejoko BO, Olaiya DS et al. Adjunctive rectal misoprostol versus oxytocin infusion for prevention of postpartum hemorrhage in women at risk: a randomized controlled trial. J Obstet Gynaecol Res. 2012 Nov;38(11):1294-1301.

Biswas SP, Halder S, Shirin FB. Indications and outcome of relaparotomy after cesarean section. Bang Med J (Khulna). 2012;45:19-23.

Fazari AB, Eldeen NS, Mohammed W, Muror M, Gailii E. Re-laparotomy after caesarean section at omdurman maternity hospital-Khartoum, Sudan. Open J Obstet Gynecol. 2015 Jul;5(08):448-54.

Lurie S, Sadan O, Golan A. Re-laparotomy after cesarean section. Eur J Obstet Gynecol Reprod Biol. 2007 Oct 1;134(2):184-7.

Downloads

Published

2018-03-27

Issue

Section

Original Research Articles