IJSR - International Journal of Scientific Research

Dr. Pankaj Kumar; Dr. Rakesh Kumar; Dr. Hari shankar Prasad; Dr. Om Prakash Bharti

Volume : VI, Issue : V, May - 2017

Prospective study to compare outcome between primary repair versus stoma formation in cases of emergency laparotomies

Dr. Pankaj Kumar, Dr. Rakesh Kumar, Dr. Hari Shankar Prasad, Dr. Om Prakash Bharti

Abstract :

Background – choice of surgery is difficult in managing emergency surgeries so we reviewed the management regarding the decision of type of surgery and morbidity. Material and method – a prospective study was conducted by including 120 patients underwent emergency laparotomy for various indications at department of surgery JLNMCH Bhagalpur Bihar from feb 2016 to jan2017. Half of the patient underwent for primary repair while other half underwent stoma formation. Patients were assessed for pertinent clinical information and individuals requiring either of the two surgeries were compared. Result –Non– traumatic perforation constituted 61% of indication for Primary repair and Stoma formation. An adverse set of preoperative and intraoperative parameters were found in patients who underwent Stoma formation compared to Primary repair group. Wound infection was the most common complication (30%) and (26%)in group A and group B respectively. Overall mortality was 8%. Morbidity, in either groups, is significantly influenced by an advanced age, a low Hb, hypoalbuminemia, an advanced lag period (>72 hours) and poor hemodynamic stability at the time of operation. The mean duration of hospital stay following either PR or SF is 10±3 days. PR is a safe procedure in emergency surgeries as long as patient is stable preoperatively and peritoneal cavity is non– compromised. SF seems to be a better option in adverse patient conditions. Patient outcome is influenced by poor clinical parameters and patient demographic in either surgery.