Retrospective Evaluation of Surgical Indications and Complication Etiologies

Abstract

Background: Urgent abdominal Re-exploration (UARs), the life-saving & obligatory operations, are performed for the treatment of number of complications that occurs after gynecological & obstetrical surgeries. Objective: The objective of the study was to evaluate the indications and causes of complication in previous surgery. Materials and Method: This cross-sectional type of descriptive study carried out at Obs and Gynae Department of Rajshahi Medical College Hospital. We studied patients age, party, type of surgery & span of hospital stays. All the patients undergoing relaparotomies following Gynecological & Obstetrical surgeries. Results: From November 2011 to April 2012, there were 41 cases where relapaparotomy needed. Relapotomy following cesarean section (6) & TAH (1) whose previous surgery was done in RMCH. The number of referred cases were 35 in number. Cases with LUCS is 34 in number & with TAH 7 in number. Indications of relaparotomy: Intraperitoneal Haemorrhage (26.83%), pyoperitoneum (26.83%), Post-partum Haemorrhage(29.26): Primary (7.32%), & secondary (21.95%), Rectus sheath haematma (12.20%), Brust abdomen (4.88%). Procedures undertaken during relaparotomy: Subtotal hysterectomy (41.46%), Total abdominal hysterectomy (9.76%), Resuturing of uterine wound (4.88%), Drainage of blood clots from undersurface of rectus sheath & peritoneal cavity toileting (12.20%), drainage of blood clot from intraabdominal cavity & resuturing of haematoma (19.51%), Drainage of pus from peritoneal cavity (24.39%). Conclusion: Although the rate of relaparotomy following gynaecological & obstetrical surgeries are low, several actions must be undertaken to decrease the need for relaparotomy. The majority of these was preventable and could have been avoided if adequate attention was paid at the time of primary surgery.