Etude des relaparotomies précoces aux Hôpitaux Universitaires de Lubumbashi: aspects épidémiologiques, cliniques et thérapeutiques

Early relaparotomies due to post operative peritonitis (POP) are surgical emergencies associated with a poor prognosis. This study aimed to describe the epidemiological, clinical and therapeutic features of early relaparotomies treated at the University Hospitals in Lubumbashi. We conducted a cross-sectional, descriptive study in two Hospitals in the health district of Upper Katanga, such as the University Clinics of Lubumbashi (UCL) and the General Referral Hospitals Jason Sendwe (GRH JS). This study included 56 patients undergoing 68 abdomen operations from 01 January 2012 to 31 December 2013. The medical records of mixed-gender patients aged 07 days to 83 years undergoing early abdomen surgery at least twice were reviewed. Epidemiological clinical, therapeutic data as well as postoperative outcome data were collected, entered and then examined using Epi Info 2011. During this study, 304 patients underwent laparotomy, of whom 248 had a favorable outcome while 56 underwent 68 relaparotomies (38 men and 18 women). The average age of patients was 34.6 ± 19 years. The average length of stay in hospital was 56.26 ± 51.82 days. Relaparotomy-related comorbidities were arterial hypertension, cancer and poor physical status, classified as ASA 3 and 4 before laparotomy, accounting for 34.62% (n=9); 26.92% (n=7) and 41.38% (n=12) respectively. General malaise, abdominal circumference increased of more than 2 cm per day at the level of the umbilicus as well diffuse and induced abdominal pain were found in 94.64% (n=53), 98.21% (n=55) and 83.93% (n=47) of cases respectively. Emergency laparotomy was performed in 51 (91.07%) patients. Laparotomy-related infections were the primary indication for reoperation in 55.36% of cases (n=31). Initial laparotomy was performed by a non-qualified surgeon in 60.71% of cases (n=34). Twelve patients who underwent reoperation died, reflecting a rate of 17.65%. Early relaparotomies for POP are commonly practiced at the University Hospitals of High Katanga. Delayed diagnosis aggravates prognosis.