Clinical outcome of early relaparotomy after elective open repair of abdominal aortic aneurysms.
OBJECTIVE
The aim of this study was to retrospectively evaluate the association of need for early relaparotomy with clinical outcomes after elective open repair of abdominal aortic aneurysms (AAAs).


METHODS
A total of 292 consecutive patients who underwent elective open AAA repair at Asan Medical Center from January 2001 to December 2010 were included in this study, and we compared the demographics, clinical characteristics, related risk factors, and clinical outcomes of early relaparotomy versus nonrelaparotomy patients.


RESULTS
The incidence of early relaparotomy during a single hospital stay was 4.1% (n = 12), and the most common causes were bowel ischemia (n = 5, 41.7%) and postoperative bleeding (n = 3, 25.0%). Among the demographics and clinical characteristics significantly associated with relaparotomy were: age (P = 0.025), chronic obstructive pulmonary disease (COPD) (P = 0.010), number of RBC units transfused during the AAA repair (P = 0.022) and in the following week (P = 0.005), and length of intensive care (P < 0.001) and overall hospital stay (P < 0.001). On multivariate analysis, presence of COPD (P = 0.009) and number of RBC units transfused during the AAA repair (P = 0.006) were statistically significantly associated with relaparotomy. Furthermore, early relaparotomy was associated with perioperative (within 30 days) (P = 0.048) and overall in-hospital mortality (P = 0.001).


CONCLUSIONS
Early relaparotomy has an adverse effect on clinical outcomes: increased mortality and hospital length of stay. Presence of COPD and need for RBC transfusion are associated with early relaparotomy.
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Youngjin
Y
Han
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Tae-Won
TW
Kwon
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Gi-Young
GY
Ko
Department of Surgery, Ulsan University Hospital, Ulsan, Korea.
Hojong
H
Park
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Ji Yoon
JY
Choi
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Yong-Pil
YP
Cho
Abdominal aortic aneurysm; Laparotomy; Treatment outcome; Vascular surgical procedures