CAUSES OF EARLY RELAPAROTOMIES IN SURGERY

Abstract

Summary. Introduction. Despite the introduction of modern methods of diagnosis, tactics, and treatment of diseases of the abdominal organs, the risk of developing early postoperative complications remains high.
 The aim of this study is to clarify the causes of early postoperative complications and indications for their surgical treatment.
 Materials and methods. 3947 case histories of patients operated on for urgent indications were analyzed. In 73 cases, relaparotomies were performed in the early postoperative period (1.85 %).
 Results and discussion. The main nosologic unit, during the surgical treatment of which relaparotomies were performed, was acute appendicitis. Then there was a perforated pyloroduodenal ulcer and a strangulated hernia of various localization. The main indications for relaparotomy were progressive peritonitis, early adhesive intestinal obstruction, intra-abdominal abscesses, and infiltrates. In two cases, no pathology was detected during relaparotomy – there was an over diagnosis of postoperative peritonitis and anastomotic suture failure.
 Conclusion. 1. The main cause for relaparotomies in urgent surgery is the progression of preoperative peritonitis. 2. The second important cause is early postoperative adhesive intestinal obstruction. 3. Errors in intraoperative diagnostics, tactics, and techniques are the third leading cause of early relaparotomies.