Contained Laparostomy With a Bogota Bag. Results of Case Series

Abstract

IntroductionThe «Bogota bag» (BB) is one of the options for contained laparostomy (CL). The aim of this study was to report the procedure associated hospital morbidity (PAHM) in patients undergoing relaparotomy followed by a laparostomy using the BB. Material and methodBetween 2002 and 2008, a prospective series of patients who underwent relaparotomy at the Hospital Hernán Henríquez, Temuco (Chile) was evaluated. The main end point was “development of PAHM”. Secondary end points were: indications of the CL, time to first change of the BB, type of abdominal wall repair, hospital mortality and development of ventral hernia. Descriptive statistics were used, with the calculations of percentages and measures of central tendency and dispersion. ResultsThe BB was used in 86 patients (median age of 53 years, 63% female). The PAHM was 38% (surgical-site infection and enterocutaneous fistula). The most frequent indication of CL was intra-abdominal sepsis (60%). The median time until the first change of the BB, the time period between surgical operations, and the time until removal of the BB were 65 hours, 2 days and 9 days, respectively. Laparostomy was repaired exclusively with skin, fascial closure or dermal-epidermal graft in 50, 39 and 10%, respectively. Inhospital mortality was 12%. Sixty percent of the patients developed a ventral hernia within a 48 month follow-up. ConclusionsCL with a BB is associated with a high rate of PAHM and delayed complications.