A Comparative Study on The Post Operative Complications in Elective and Emergency Laparotomies

Abstract

Introduction: Laparotomy is one of the common surgical procedure nowadays. The complications that occur in the post operative period determines the outcome.

Materials and Methods: A comparitive study on Post operative complications in elective versus emergency laparotomies done in our Instituition (Thanjavur Medical college Hospital). The study period was of 2 years (August 2014 to July 2016). The two groups(elective and emergency) were followed up and studied for a period of two months and the post operative complications were recorded. The nature of study was quantitative. Participants were selected between the ages of 13-70 to keep the homogeneity of the group. The study comprised all patients who have undergone laparotomy in our institution during the study period. 79 people were undertaken for elective laparotomy group and 100 to the emergency laparotomy and the total respondents were 179.

Results and Conclusion: Among 179 respondents most of the respondents had Acute abdomen/peritonitis as an indication for laparotomy. 25.1% were in the age group of 46-55 years, 64.2% males and 35.8 % females. The surgery was performed for 1 to 2 hours in 64.2% of the respondents. Among 34.1% of them duration was less than 1 hour and more than 2 hours of duration 1.7% of the respondents. Post operative complications were observed in 53.2% of the respondents,70% of them were those who underwent emergency laparotomies Post operative vomiting  and nausea was observed in 12.3% of the respondents. Commonly seen in those undergoing emergency laparotomy. Post operative fever was commonly observed in respondents who underwent emergency laparotomy. Post operative pulmonary complications were observed in 16.8% and also commonly with emergency laparotomy group. Postoperative wound infection rate was more in emergency laparotomy group(28 %). Enterocutaneous fistula was seen in 1.7% of the respondents and was only in those undergoing emergency laparotomy. Paralytic ileus was seen in 19% of the respondents with emergency laparotomies. 9% ,11%,3% of the respondents had anastamotic dehiscence, septicaemia and  adhesive intestinal obstruction respectively in emergency laparatomies. 39.2% of the respondents who had right subcoastal incision on elective laparotomy had incisional hernia and none had in emergency laparotomy group. Emergency laparotomies were associated with more mortality in our study.