非创伤性患者术后意外打开腹壁:突尼斯的一项单中心回顾性研究

A. Hasnaoui, D. Haddad, H. Zaafouri, A. Bouhafa, Anis Ben Maamer
{"title":"非创伤性患者术后意外打开腹壁:突尼斯的一项单中心回顾性研究","authors":"A. Hasnaoui, D. Haddad, H. Zaafouri, A. Bouhafa, Anis Ben Maamer","doi":"10.15342/ijms.v5iR.195","DOIUrl":null,"url":null,"abstract":"Introduction:  Unintentional post-operative open abdominal wall (UPOAW) is a postoperative complication that consists of the early separation of the fascial layer after a primary closure of a laparotomy incision. This complication is associated with great morbidity and mortality. In this article, we studied the frequency of some of these known factors in our series and we briefly discussed the management of this complication. Methods:  It was a monocentric retrospective and descriptive study. We enrolled patients with UPOAW, admitted in the department of surgery in Habib Thameur hospital in Tunis (Tunisia), between January 2010 and December 2015.We did not include traumatic patients. We excluded patients with missing data from medical records. Results:  The study was conducted on fifteen patients. Eight out of fifteen were men. Patients were aged between 41 and 76 years, with a mean age of 66.6 ± 11.4 years. In the past medical history, chronic obstructive pulmonary disease was noted in three patients, cirrhosis in three patients, diabetes in one patient and a history for laparotomy in one patient. Eight out of fifteen underwent emergent surgeries. Two out of these eight patients had haemodynamic instability throughout surgery. In the postoperative course, coughing was noted in three patients, abdominal distension from ileus in three patients, vigorous postoperative ventilation in two patients and vomiting in one patient. UPOAW was diagnosed between postoperative day zero and postoperative day twenty-one, with a mean time of diagnosis of 10.1 ± 6.6. All patients had immediate closure of the fascial layer. The surgeon used retro-fascial polyglactin mesh in three patients. Relaxing incisions were used in 5 patients. Morbidity after reoperation was 46.7 % (7/15) and mortality was 33.3 % (5/15). Conclusion:  UPOAW is a serious complication with high morbidity and mortality. Many factors can contribute to this complication. Every visceral surgeon is confronted with this problem at some point of his carrier and should apply the adequate treatment to his patients depending on his decision and experience. Strong level of evidence is needed to establish clear guidelines for the management of this heterogenous complication.","PeriodicalId":259657,"journal":{"name":"International Journal of Medicine and Surgery","volume":"55 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2018-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"UNINTENTIONAL POST-OPERATIVE OPEN ABDOMINAL WALL IN NON-TRAUMATIC PATIENTS: A MONOCENTRIC RETROSPECTIVE STUDY IN TUNISIA\",\"authors\":\"A. Hasnaoui, D. Haddad, H. Zaafouri, A. Bouhafa, Anis Ben Maamer\",\"doi\":\"10.15342/ijms.v5iR.195\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Introduction:  Unintentional post-operative open abdominal wall (UPOAW) is a postoperative complication that consists of the early separation of the fascial layer after a primary closure of a laparotomy incision. This complication is associated with great morbidity and mortality. In this article, we studied the frequency of some of these known factors in our series and we briefly discussed the management of this complication. Methods:  It was a monocentric retrospective and descriptive study. We enrolled patients with UPOAW, admitted in the department of surgery in Habib Thameur hospital in Tunis (Tunisia), between January 2010 and December 2015.We did not include traumatic patients. We excluded patients with missing data from medical records. Results:  The study was conducted on fifteen patients. Eight out of fifteen were men. Patients were aged between 41 and 76 years, with a mean age of 66.6 ± 11.4 years. In the past medical history, chronic obstructive pulmonary disease was noted in three patients, cirrhosis in three patients, diabetes in one patient and a history for laparotomy in one patient. Eight out of fifteen underwent emergent surgeries. Two out of these eight patients had haemodynamic instability throughout surgery. In the postoperative course, coughing was noted in three patients, abdominal distension from ileus in three patients, vigorous postoperative ventilation in two patients and vomiting in one patient. UPOAW was diagnosed between postoperative day zero and postoperative day twenty-one, with a mean time of diagnosis of 10.1 ± 6.6. All patients had immediate closure of the fascial layer. The surgeon used retro-fascial polyglactin mesh in three patients. Relaxing incisions were used in 5 patients. Morbidity after reoperation was 46.7 % (7/15) and mortality was 33.3 % (5/15). Conclusion:  UPOAW is a serious complication with high morbidity and mortality. Many factors can contribute to this complication. Every visceral surgeon is confronted with this problem at some point of his carrier and should apply the adequate treatment to his patients depending on his decision and experience. Strong level of evidence is needed to establish clear guidelines for the management of this heterogenous complication.\",\"PeriodicalId\":259657,\"journal\":{\"name\":\"International Journal of Medicine and Surgery\",\"volume\":\"55 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2018-05-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Medicine and Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.15342/ijms.v5iR.195\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Medicine and Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.15342/ijms.v5iR.195","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

前言:术后不故意开放腹壁(UPOAW)是一种术后并发症,包括剖腹手术切口初次闭合后早期筋膜层分离。这种并发症具有很高的发病率和死亡率。在本文中,我们研究了这些已知因素在我们的系列中出现的频率,并简要讨论了这种并发症的处理。方法:采用单中心回顾性和描述性研究。我们招募了2010年1月至2015年12月期间在突尼斯(突尼斯)Habib Thameur医院外科收治的UPOAW患者。我们没有包括创伤患者。我们排除了病历中数据缺失的患者。结果:本研究共纳入15例患者。15人中有8人是男性。患者年龄41 ~ 76岁,平均年龄66.6±11.4岁。既往病史中,慢性阻塞性肺疾病3例,肝硬化3例,糖尿病1例,开腹手术史1例。15人中有8人接受了紧急手术。8例患者中有2例在手术过程中出现血流动力学不稳定。术后3例患者出现咳嗽,3例患者出现肠梗阻引起的腹胀,2例患者出现术后剧烈通气,1例患者出现呕吐。UPOAW的诊断时间为术后第0天至术后第21天,平均诊断时间10.1±6.6。所有患者均立即封闭筋膜层。外科医生在3例患者中使用了筋膜后聚乳酸补片。5例采用松弛切口。术后再手术发生率46.7%(7/15),死亡率33.3%(5/15)。结论:UPOAW是一种严重的并发症,发病率和死亡率高。许多因素可导致这种并发症。每个内脏外科医生在行医过程中都会遇到这个问题,应该根据自己的决定和经验对病人进行适当的治疗。需要强有力的证据来为这种异质性并发症的治疗建立明确的指导方针。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
UNINTENTIONAL POST-OPERATIVE OPEN ABDOMINAL WALL IN NON-TRAUMATIC PATIENTS: A MONOCENTRIC RETROSPECTIVE STUDY IN TUNISIA
Introduction:  Unintentional post-operative open abdominal wall (UPOAW) is a postoperative complication that consists of the early separation of the fascial layer after a primary closure of a laparotomy incision. This complication is associated with great morbidity and mortality. In this article, we studied the frequency of some of these known factors in our series and we briefly discussed the management of this complication. Methods:  It was a monocentric retrospective and descriptive study. We enrolled patients with UPOAW, admitted in the department of surgery in Habib Thameur hospital in Tunis (Tunisia), between January 2010 and December 2015.We did not include traumatic patients. We excluded patients with missing data from medical records. Results:  The study was conducted on fifteen patients. Eight out of fifteen were men. Patients were aged between 41 and 76 years, with a mean age of 66.6 ± 11.4 years. In the past medical history, chronic obstructive pulmonary disease was noted in three patients, cirrhosis in three patients, diabetes in one patient and a history for laparotomy in one patient. Eight out of fifteen underwent emergent surgeries. Two out of these eight patients had haemodynamic instability throughout surgery. In the postoperative course, coughing was noted in three patients, abdominal distension from ileus in three patients, vigorous postoperative ventilation in two patients and vomiting in one patient. UPOAW was diagnosed between postoperative day zero and postoperative day twenty-one, with a mean time of diagnosis of 10.1 ± 6.6. All patients had immediate closure of the fascial layer. The surgeon used retro-fascial polyglactin mesh in three patients. Relaxing incisions were used in 5 patients. Morbidity after reoperation was 46.7 % (7/15) and mortality was 33.3 % (5/15). Conclusion:  UPOAW is a serious complication with high morbidity and mortality. Many factors can contribute to this complication. Every visceral surgeon is confronted with this problem at some point of his carrier and should apply the adequate treatment to his patients depending on his decision and experience. Strong level of evidence is needed to establish clear guidelines for the management of this heterogenous complication.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信