title: Repeat laparotomy in a developing world tertiary level surgical service.
abstract: BACKGROUND
  Repeat laparotomy is associated with significant morbidity and mortality; however, developing world data are scarce. This study reviews the spectrum and outcomes of relaparotomy in a developing world setting.
  
  
  METHODS
  Prospectively collected data from adult patients needing repeat laparotomy over an 18-month period were analyzed.
  
  
  RESULTS
  Relaparotomy rate was 24% and average age was 38 years with a male predominance (70%). Appendicitis and trauma were the most common diagnoses. Planned relaparotomy rate was high (41%); however, negative relaparotomy rate was only 9%. Need for intensive care unit admission (51%) and morbidity rate (64%) were both high, but overall mortality rate was 14%. Patients requiring multiple relaparotomies had further worsened outcomes.
  
  
  CONCLUSIONS
  The need for repeat laparotomy in the developing world is high and it is associated with significant morbidity and need for intensive care unit admission. However, mortality rates and negative repeat laparotomy rates were low.
authors.affiliation: Department of Surgery, Pietermaritzburg Hospital Complex, University of KwaZulu Natal, Townbush Road, Pietermaritzburg, KwaZulu-Natal, South Africa.
authors.forename: Matthias F
authors.initials: MF
authors.lastname: Scriba
authors.affiliation: Department of Surgery, Pietermaritzburg Hospital Complex, University of KwaZulu Natal, Townbush Road, Pietermaritzburg, KwaZulu-Natal, South Africa.
authors.forename: Grant L
authors.initials: GL
authors.lastname: Laing
authors.affiliation: Department of Surgery, Pietermaritzburg Hospital Complex, University of KwaZulu Natal, Townbush Road, Pietermaritzburg, KwaZulu-Natal, South Africa.
authors.forename: John L
authors.initials: JL
authors.lastname: Bruce
authors.affiliation: Department of Surgery, Pietermaritzburg Hospital Complex, University of KwaZulu Natal, Townbush Road, Pietermaritzburg, KwaZulu-Natal, South Africa. Electronic address: damianclar@gmail.com.
authors.forename: Damian L
authors.initials: DL
authors.lastname: Clarke
mesh_terms: D000007:Abdominal Injuries / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D000328:Adult; D015331:Cohort Studies; D003422:Critical Care; D003906:Developing Countries; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007813:Laparotomy / Q000009:adverse effects* / Q000401:mortality*; D008297:Male; D018579:Patient Selection; D012086:Reoperation; D012307:Risk Factors; D013019:South Africa
keywords: Developing world; Outcomes; Relaparotomy