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The Problem of Early Surgical Revisions After Abdominal Surgery, Study About 83 Cases Recorded in Bangui, Central African Republic

Received: 7 August 2021     Accepted: 23 August 2021     Published: 24 November 2021
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Abstract

Objectives: To describe the characteristic of reoperated patients, the predictive factors of morbidity and mortality as well as the evolution after early reoperations. Materials and method: The study included a retrospective and prospective series. The files of patients reoperated after abdominal surgery from January 2014 to December 2019 at the general surgery department of Sino-Central African Friendship University Hospital in Bangui were analyzed. Results: Out of 1249 patients operated on and hospitalized in the surgical department and, 83 (6.6%) patients were reoperated. They were 53% male subjects. The average age was 38.4 years old. An initial intervention was carried out urgently by unqualified operators (71.1%). Postoperative peritonitis (42.2%) was the main reasons for reoperation. Time to reoperation was 8.4 days on average. The founding during reoperation was anastomotic disunity (39.8%). A bypass stoma (33.7%) associated with washing and drainage of the peritoneal cavity was performed. In 19.2% of cases, patients underwent iterative reoperation. The rate of death was 24%. Predictive factors of poor prognosis were, initial surgery for acute peritonitis, dirty surgery, patient with ASA score II and III, NISS 2 and 3, unqualified operators, iterative reoperations and digestive fistula. Conclusion: Early re-operations occurred after emergency surgery performed by an unqualified surgeon. They dependent on high mortality. To reduce rate of early reoperations and improve the prognosis, qualified surgical personnel are needed. Unqualified surgeons must be regularly retrained in essential surgical care with particular emphasis on respecting the basic principles of emergency surgery.

Published in International Journal of Biomedical Engineering and Clinical Science (Volume 7, Issue 4)
DOI 10.11648/j.ijbecs.20210704.13
Page(s) 81-85
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Surgical Reoperation, Abdominal Surgery, Surgical Emergencies

References
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[2] CHICHOM M A, TCHOUNZOUA R, MASSO MISSEB P, PISOHC C, PAGBED JJ, ESSOMBAB A et al. Réinterventions de chirurgie abdominale en milieu défavorisé: indications et suites opératoires (238 cas). J Chir 2009; 146: 387-91.
[3] SALEH C, KASHAL M, SANGWA C, WAKANGA G, TSHILOMBO F, ODIMBA E et al. Etude des relaparotomies précoces aux Hôpitaux Universitaires de Lubumbashi: aspects épidémiologiques, cliniques et thérapeutiques. Pan Afr Med J. 2018; 30: 1-10.
[4] BRUGERE C, PIRLET I, GUILLON F, MILLAT B. Gestion des complications chirurgicales et indications de reprises. Mapar. 2009; 232: 32-6.
[5] MONTRAVERS P, EL HOUSSEINI L, REKKIK R. Les péritonites post opératoires: diagnostic et indications des réinterventions. Soc Réa lang franc. 2004; 13: 431-35.
[6] WACHA H, LINDER MM, FELDMANN U, WESCH G, GUNDLACH E, STEIFENSAND RA. Mannheim Peritonitis Index - prediction of risk of death from peritonitis: construction of a statistical and validation of an empirically based index. Theor Surg 1987; 1: 169-77.
[7] LAMME B, BOERMEESTER MA, REITSMA JB, MAHLER CW, OBERTOP H, GOUMA DJ. Meta-analysis of relaparotomy for secondary peritonitis. Br J Surg. 2002; 89: 1516-24.
[8] HINSDALE JG, JAFFE BM. Ré-operation for intra-abdominal sepsis: Indications and result in modern critical care setting. Ann Surg. 1984; 199 (1): 31-6.
[9] KHURRUM BM, HUA R, BATISTA O, URIBURU JP, SINGH JJ, WEISS EG, NOGUERAS JJ, WEXNER SD. Percutaneous postoperative intra-abdominal abscess drainage after elective colorectal surgery Tech Coloproctol. 2002; 6: 159-64.
[10] ASSOUTO P, TCHAOU B, KANGNI N, PADONOU JL, LOKOSSOU T, DJICONKPODE P et al. Evolution post opératoire précoce en chirurgie digestive en milieu tropical. Med Trop. 2009; 69: 477-79.
[11] LAU W, FAN S, CHU KW, YIP W., YUEN W., WONG K. Influence of surgeons’ experience on postoperative sepsis. Am J Surg. 1988; 155: 322-26.
[12] TONYE TA, ESSI MJ, HANDY ED, ANKOUANE A, MINKA NGOM E, NGO NONGA B et al. Complications post opératoire précoces dans les Hôpitaux de district de la ville de Yaoundé: épidémiologie et clinique. Health Sci Dis J. 2015; 16: 1-3.
[13] BAHI M. et al. Les reprises chirurgicales en pathologie digestive: Facteurs étiologiques et pronostiques: http//ao.um5s.ac.ma/xmlui/handle/123456789/997.
[14] HUTCHINS RR, GUNNING MP, LUCAS DN, ALLEN-MERSH TG, SONI NC: Relaparotomie for suspected intraperitoneal septis after abdominal surgery. World J. Surg. 2004, 28: 137-41.
[15] CARLET J, BOUHAJA B, BLERIOT J, DAZZA F. Infections péritonéales postopératoires. In: REGNIER B, BRUN-BUISSON C. L'infection en réanimation. Masson. Paris. 1988; 14: 126-38.
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    Doui Doumgba Antoine, Piamale Germain, Damassara Kokonga Innocent, Ngboko Mirotiga Pétula Anicette. (2021). The Problem of Early Surgical Revisions After Abdominal Surgery, Study About 83 Cases Recorded in Bangui, Central African Republic. International Journal of Biomedical Engineering and Clinical Science, 7(4), 81-85. https://doi.org/10.11648/j.ijbecs.20210704.13

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    ACS Style

    Doui Doumgba Antoine; Piamale Germain; Damassara Kokonga Innocent; Ngboko Mirotiga Pétula Anicette. The Problem of Early Surgical Revisions After Abdominal Surgery, Study About 83 Cases Recorded in Bangui, Central African Republic. Int. J. Biomed. Eng. Clin. Sci. 2021, 7(4), 81-85. doi: 10.11648/j.ijbecs.20210704.13

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    AMA Style

    Doui Doumgba Antoine, Piamale Germain, Damassara Kokonga Innocent, Ngboko Mirotiga Pétula Anicette. The Problem of Early Surgical Revisions After Abdominal Surgery, Study About 83 Cases Recorded in Bangui, Central African Republic. Int J Biomed Eng Clin Sci. 2021;7(4):81-85. doi: 10.11648/j.ijbecs.20210704.13

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  • @article{10.11648/j.ijbecs.20210704.13,
      author = {Doui Doumgba Antoine and Piamale Germain and Damassara Kokonga Innocent and Ngboko Mirotiga Pétula Anicette},
      title = {The Problem of Early Surgical Revisions After Abdominal Surgery, Study About 83 Cases Recorded in Bangui, Central African Republic},
      journal = {International Journal of Biomedical Engineering and Clinical Science},
      volume = {7},
      number = {4},
      pages = {81-85},
      doi = {10.11648/j.ijbecs.20210704.13},
      url = {https://doi.org/10.11648/j.ijbecs.20210704.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijbecs.20210704.13},
      abstract = {Objectives: To describe the characteristic of reoperated patients, the predictive factors of morbidity and mortality as well as the evolution after early reoperations. Materials and method: The study included a retrospective and prospective series. The files of patients reoperated after abdominal surgery from January 2014 to December 2019 at the general surgery department of Sino-Central African Friendship University Hospital in Bangui were analyzed. Results: Out of 1249 patients operated on and hospitalized in the surgical department and, 83 (6.6%) patients were reoperated. They were 53% male subjects. The average age was 38.4 years old. An initial intervention was carried out urgently by unqualified operators (71.1%). Postoperative peritonitis (42.2%) was the main reasons for reoperation. Time to reoperation was 8.4 days on average. The founding during reoperation was anastomotic disunity (39.8%). A bypass stoma (33.7%) associated with washing and drainage of the peritoneal cavity was performed. In 19.2% of cases, patients underwent iterative reoperation. The rate of death was 24%. Predictive factors of poor prognosis were, initial surgery for acute peritonitis, dirty surgery, patient with ASA score II and III, NISS 2 and 3, unqualified operators, iterative reoperations and digestive fistula. Conclusion: Early re-operations occurred after emergency surgery performed by an unqualified surgeon. They dependent on high mortality. To reduce rate of early reoperations and improve the prognosis, qualified surgical personnel are needed. Unqualified surgeons must be regularly retrained in essential surgical care with particular emphasis on respecting the basic principles of emergency surgery.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - The Problem of Early Surgical Revisions After Abdominal Surgery, Study About 83 Cases Recorded in Bangui, Central African Republic
    AU  - Doui Doumgba Antoine
    AU  - Piamale Germain
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    AU  - Ngboko Mirotiga Pétula Anicette
    Y1  - 2021/11/24
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ijbecs.20210704.13
    DO  - 10.11648/j.ijbecs.20210704.13
    T2  - International Journal of Biomedical Engineering and Clinical Science
    JF  - International Journal of Biomedical Engineering and Clinical Science
    JO  - International Journal of Biomedical Engineering and Clinical Science
    SP  - 81
    EP  - 85
    PB  - Science Publishing Group
    SN  - 2472-1301
    UR  - https://doi.org/10.11648/j.ijbecs.20210704.13
    AB  - Objectives: To describe the characteristic of reoperated patients, the predictive factors of morbidity and mortality as well as the evolution after early reoperations. Materials and method: The study included a retrospective and prospective series. The files of patients reoperated after abdominal surgery from January 2014 to December 2019 at the general surgery department of Sino-Central African Friendship University Hospital in Bangui were analyzed. Results: Out of 1249 patients operated on and hospitalized in the surgical department and, 83 (6.6%) patients were reoperated. They were 53% male subjects. The average age was 38.4 years old. An initial intervention was carried out urgently by unqualified operators (71.1%). Postoperative peritonitis (42.2%) was the main reasons for reoperation. Time to reoperation was 8.4 days on average. The founding during reoperation was anastomotic disunity (39.8%). A bypass stoma (33.7%) associated with washing and drainage of the peritoneal cavity was performed. In 19.2% of cases, patients underwent iterative reoperation. The rate of death was 24%. Predictive factors of poor prognosis were, initial surgery for acute peritonitis, dirty surgery, patient with ASA score II and III, NISS 2 and 3, unqualified operators, iterative reoperations and digestive fistula. Conclusion: Early re-operations occurred after emergency surgery performed by an unqualified surgeon. They dependent on high mortality. To reduce rate of early reoperations and improve the prognosis, qualified surgical personnel are needed. Unqualified surgeons must be regularly retrained in essential surgical care with particular emphasis on respecting the basic principles of emergency surgery.
    VL  - 7
    IS  - 4
    ER  - 

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Author Information
  • Department of Surgery and Surgical Specialties, Health Sciences Faculty, Bangui University, Bangui, Central African Republic

  • Public Health Department, Doctoral School of Human and Veterinary Health Sciences, Health Sciences Faculty, Bangui University, Bangui, Central African Republic

  • Surgery Department, University Hospital Center Mom Elisabeth Domitien of Bimbo, Bimbo, Central African Republic

  • General and Visceral Surgery Department, Sino-central African Friend Ship University Hospital, Bangui, Central African Republic

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