Research Article
Volume 8 Issue 11 - 2021
Factors Influencing the Mortality of Early Reoperations Following Laparotomies at Kamenge University Teaching Hospital in Burundi
Jean Claude Mbonicura1,3*, Sylvain Niyonkuru2, Clovis Paulin Baramburiye1,3, Yves Bizoza1, François Nduwimana1, Emile Horugavye1 and Ferdinand Niyonzima1
1General Surgery, Kamenge University Teaching Hospital, University of Burundi, Bujumbura, Burundi
2General Surgery, Kira Hospital, Bujumbura, Burundi
3General Surgery, College of Surgeons of Eastern Central and Southern Africa, Tanzania
*Corresponding Author: Jean Claude Mbonicura, General Surgery, Kamenge University Teaching Hospital, University of Burundi, Bujumbura, Burundi.
Received: September 14, 2021; Published: October 20, 2021




Abstract

Aim: Identify the factors which influence the mortality of early reoperations following laparotomies at Kamenge University Teaching Hospital (KUTH).

Patients and Methods: It is a retrospective study analyzing on ten years. We have analyzed medical records of patients who had a reoperation during the same hospital stay or in the 30 days following the primary surgery.

Results: During the study period, 1249 patients underwent laparotomy and 48 of them (3.84%) have been reoperated with an overall mortality rate of 18.75%. The indications of the reoperation were mainly clinical, and the main ones were post-op peritonitis in 43.75% with a mortality rate of 14.5%, anastomotic leaks in 12.5% of the patients and an associated mortality of 60%, intestinal obstruction and surgical site infection in 12.5% of the cases both and severe hemorrhage in 10.41% of the patients with a mortality rate of 25%. The overall mortality rate was 18.75% and was also the highest in groups with advanced age, patients operated urgently, and patients reoperated early compared to the primary surgery.

Conclusion: Advanced age, septic and hemorrhagic complications, procedures performed urgently with unprepared patients and the short time span between the primary surgery and the reoperation are the main factors increasing the mortality rate of early reoperations following laparotomies. This rate which is not negligeable could be decreased by avoiding some of the complications leading to a reoperation in the first place such as septic and hemorrhagic complications sometimes due to a care quality which is not always optimal especially in low resource areas.

Keywords: Mortality; Laparotomies; Kamenge University Teaching Hospital; Burundi

References

  1. A Chichom Mefire., et al. “Réinterventions de chirurgie abdominale en milieu défavorisé: indications et suites opératoires (238cas)”. Journal de Chirurgie 146 (2009): 387-391.
  2. Ching SS., et al. “Relaparotomy; a five-year review of indication and outcome”. International Journal of Clinical Practice 57 (2003): 333-337.
  3. Desiaterik VI., et al. “Relaparotomy: clinical, strategic and organizational aspect”. Klinicheskaia Khirurgiia 7 (2000): 35-38.
  4. Babin IA and Koval'chuk AZ. “The use of relaparotomy in emergency surgery”. Klinicheskaia Khirurgiia 4 (1993): 34-37.
  5. Kriger AG., et al. “Diagnosis and treatment of postoperative intraabdominal complications”. Khirurgiia 8 (2003): 19-23.
  6. Kriger AG., et al. “Diagnosis and treatment of acute adhesive small intestine obstruction”. Khirurgiia 7 (2001): 25-29.
  7. Rosin D., et al. “Laparoscopic management of surgical complication after a recent laparotomy”. Surgical Endoscopy 18 (2004): 994-996.
  8. Ss Ching Afrcs., et al. “Relaparotomy: a five-year review of indications and outcome. Department of surgery, Ysbyty Gwynedd, Bangor, Gwynedd”. International Journal of Contemporary Pediatrics4 (2003).
  9. Madiha Koubaa Kharrat., et al. “La mortalité des réinterventions précoce après chirurgie gastro-duodénale, à propos de 36 Cas”. Tunisia Chirurgia (2003): 241-248.
  10. R Aghzadi-traki., et al. “Les réinterventions précoces en chirurgie abdominale d’urgence. A propos de 80 cas”. Journal de Medecine De Strasbourg7 (1991): 346-347.
  11. Stoppa R. “Les réinterventions précoces en chirurgie abdominale: Réflexion tirées de l’étude de 149 cas”. Revolution Medicines Picardi 10 (1982): 166-172.
  12. Rasamoelina N., et al. “Facteurs de mortalité par les urgences digestives dans le service de réanimation du CHU de Fianarantsoa Madagascar”. Rev Afr Anesth Rea Urg.2 (2010) :10-11.
  13. Ibrahima Gaye., et al. “Prise en charge péri opératoire des urgences chirurgicales abdominales chez l’adulte au CHU Aristide Le Dantec”. Pan African Medical Journal 24 (20016): 190.
  14. Tonye TA., et al. “Complications postoperatoires précoces dans les hopitaux de district de la ville de Yaoundé. Epidémiologie et Clinique, Cameroun”. Health Sciences1 (2015).
  15. Ahmedou Moulaye Idriss., et al. “Applicability of the Clavien-Dindo classification in the evaluation of postoperative complications at the Surgery Department of the National Hospital Center of Nouakchott: observational study of 834 cases”. Pan African Medical Journal 33 (2019): 254.
  16. Catherine Saleh Ugumba., et al. “Etude des relaparotomies précoces aux Hôpitaux Universitaires de Lubumbashi: aspects épidémiologiques, cliniques et thérapeutiques”. Pan African Medical Journal 30 (2018): 127.
  17. JC Mbonicura., et al. “Facteurs prédictifs de mortalité des Sepsis intra-péritonéaux postopératoires (SIPPO) au CHU de Kamenge (Burundi)”. JACCR Infectiology3 (2020): 16-21.
Citation: Jean Claude Mbonicura., et al. “Factors Influencing the Mortality of Early Reoperations Following Laparotomies at Kamenge University Teaching Hospital in Burundi”. EC Gastroenterology and Digestive System 8.11 (2021): 34-38.

PubMed Indexed Article


EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005


EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777


EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347


EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478


EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253


EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033


EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723


EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726


EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603


EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646


EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616


EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290


EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226


EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812


EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268


News and Events


July Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the July issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before July 15, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.