• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.17
• /
• pp.7765-7768
• /
• 2015

This study was conducted to determine the incidence of wound complications after laparotomy for endometrial cancer and significant predictors of risks. Medical records of patients with endometrial cancer undergoing laparotomy for surgical staging at Srinagarind Hospital, Khon Kaen University between January 2007 and December 2013 were reviewed. Intravenous antibiotic prophylaxis was routinely given 30 minutes before surgery. The primary endpoint was wound complications (including seroma, hematoma, separation, or infection) requiring additional medical and/or surgical management within 4 weeks of laparotomy. During the study period, 357 patients with complete medical records were reviewed. The mean age was 56.9 years. Wound complications were observed in 28 patients (7.84%, 95% CI, 5.27% to 11.14%). Body mass index (BMI) ${\geq}30kg/m^2$, diabetes mellitus (DM), and prior abdominal surgery were observed as significant independent factors predicting an increased risk of wound complications with adjusted odds ratios (95% CIs) of 2.96 (1.23-7.16), 2.43 (1.06-5.54), and 3.05 (1.03-8.98), respectively. In conclusion, the incidence of wound complications after laparotomy for endometrial cancer was 7.8%. Significant independent predictors of risk included BMI, DM and prior abdominal surgery.

• Korean Journal of Veterinary Service
• /
• v.45 no.4
• /
• pp.293-304
• /
• 2022

Among several diseases of calves, diarrhea is the most prevalent disease and has been a major cause of economic loss to the cattle industry. The main etiologic agents of diarrhea in calves are bacteria, viruses, and protozoa, but non-infectious factors including foreign bodies obstruction in the digestive system also focused as the cause of calf diarrhea in the recent days. Because there is still limited information for foreign body-related diarrhea in calves, especially in Hanwoo, the present retrospective study reviewed the medical records for diarrheic calves with foreign body in the digestive system (n=32). The morbidity was determined as 3.03% and more than half of them presented the acidosis, hyponatremia, and azotemia. The mortality in laparotomy-operated calves to remove foreign bodies or in non-operated ones was 28% or 85.7%, respectively, implied the importance of aggressive decision for laparotomy when the foreign bodies were determined in the digestive system in diarrheic calves. During laparotomy, trichobezoars (hair balls) and hays were the main foreign bodies and prevalently placed in the abomasum. In the trials to predict prognosis by several clinical factors, the time for laparotomy over 2 days after first diagnosis, acidosis, and foreign body in the abomasum were highly associated with mortality. Therefore, we believe that prompt surgical procedure (laparotomy) is necessary upon obstruction in the digestive system by foreign bodies is tentatively diagnosed in the diarrheic calf. In addition, when differential diagnosis list is made, foreign body-related diarrhea is necessary to be included in case of diarrheic calf.

• Journal of Trauma and Injury
• /
• v.37 no.2
• /
• pp.140-146
• /
• 2024

Purpose: Despite the high incidence of abdominal stab injuries, the rate of nontherapeutic laparotomies and the predictors of therapeutic laparotomies have rarely been studied in low-income settings. Methods: This multicenter retrospective study involved three of the largest academic medical centers in central Ethiopia. All patients who sustained an anterior abdominal stab injury and underwent exploratory laparotomy, regardless of the intraoperative findings, were included over the 3-year course of the study. Results: Of the 117 patients who underwent exploratory laparotomy, 35 patients (29.9%) underwent nontherapeutic laparotomies. Three factors predicted therapeutic laparotomy: hollow viscus evisceration (adjusted odds ratio [AOR], 5.77; 95% confidence interval [CI], 1.16-28.64; P=0.032), localized and generalized peritonitis (AOR, 4.77; 95% CI, 1.90-11.93; P=0.001), and white blood cell count ≥11,500/mm³ (AOR, 2.77; 95% CI, 1.002-7.650; P=0.049). The overall positive predictive value of the therapeutic predictors was 80.2%, while the negative predictive value of all predictor-negative patients was 58.1%. The predictors would have prevented 51.4% of the nontherapeutic laparotomies. Conclusions: Close to one-third of the patients had a nontherapeutic laparotomy. The clinical predictors of therapeutic laparotomy were shown to have a high positive predictive value despite a lower negative predictive value. Further prospective studies that involve all patients who sustain anterior abdominal stab injuries are needed to potentially improve on the negative predictive value of the predictors suggested by our study.

• Journal of Veterinary Clinics
• /
• v.16 no.1
• /
• pp.50-56
• /
• 1999

This study was carried out to compare the efficacy of sodium carboxymethyl cellulose (SCMC) with the combination of low molecular weight heparin (LMWH) and SCMC for the prevention of postoperative adhesions in the dog. After laparotomy, abrasions were made on the surface of ileal serosa in 17 dogs. The animals were randomly divided into the control group (N = 5) which received no treatment, the SCMC-treated group (N = 6), and the SCMC ＆ LMWH-treated group (N = 6). Hematologic values were monitored before laparotomy and 1, 4, 7, 10 and 14 days after laparotomy. The location and score of adhesion were assessed at second laparotomy 3 weeks later, Although the mean adhesion score both in the SCMC-treated group (7.17${\pm}$1.17) and in the SCMC & LMWH-treated group (4.50${\pm}$1.38) was found to be significantly lower than that in the control group (9.40${\pm}$0.89) (p<0.01 and p＜0.01, respectively), more favorable adhesion prevention was achieved in the SCMC ＆ LMWH-treated group in comparison with the SCMC-treated group without any hemor-rhagic complications (p<0.01). This study could conclude that SCMC ＆ LMWH are highly effective in prevention against postoperative adhesion in the dog.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.7
• /
• pp.3111-3116
• /
• 2016

Background: The goal of this study was to compare the rate of recurrence and occurrence of complications in colorectal cancer patients after two kinds of laparoscopy and laparotomy. Materials and Methods: A follow-up study was carried out among 358 patients who suffered from colorectal cancer from 2012-2014. The data were gathered from colorectal research center in Shiraz, Shahid Faghihi hospital, and analyzed using the chi-square test, logistic regression, and multinomial regression. Results: The average age of these patients was $56.3{\pm}14.6$, 55.0% being men. Moreover, 57.8% of them underwent laparoscopy surgery and 42.2% of the patients underwent laparotomysurgery and the conversion rate was 58.0% which ultimately was put under the category of laparotomy surgery. After biennial median follow-up, differences in the occurrence of complications such as bleeding (hemorrhage), fever, intestine blockage and wound infection in these two kinds of surgery werestatistically significant (P<0.05). However, the rate of recurrence and the patients' ultimate status (alive without disease, alive with disease, and death) did not significantly differ between these two surgery groups. Conclusions: Post-operation complications were laparoscopy surgery were less than those in laparotomy. However, the outcomes such as patients' ultimate status and recurrence were similar between the two groups.

• Journal of Trauma and Injury
• /
• v.37 no.1
• /
• pp.83-85
• /
• 2024

Pneumoperitoneum usually presents as a surgical emergency, especially in patients with a history of trauma. However, we recently encountered an atypical case of pneumoperitoneum at a hysterectomy site following blunt trauma, indicating that immediate laparotomy may not always be necessary. In this report, we present the case of a 45-year-old woman who was transferred to our trauma center from a local hospital after being involved in a traffic accident the day before. Although she underwent an emergency laparotomy, no bowel perforation was detected. Instead, a rupture was found at the site of a hysterectomy that had been performed 8 months earlier. After repairing the hysterectomy site, the pneumoperitoneum resolved, and the patient was subsequently discharged without further complications.

• Journal of Chest Surgery
• /
• v.46 no.6
• /
• pp.467-470
• /
• 2013

The rupture of a renal artery aneurysm is a rare disease that is difficult to diagnose. Although we usually consider the appropriate treatment to be open laparotomy with aortic aneurysm surgery or stenting with graft insertion through intravascular intervention, thus far, there is no general consensus on the treatment protocol for renal artery aneurysm. Notably, ruptured renal artery aneurysm is a true critical emergency that may result in a fatal outcome. We are reporting two renal artery aneurysm patients who had ruptured and underwent emergency laparotomy.

• Journal of Trauma and Injury
• /
• v.23 no.2
• /
• pp.180-187
• /
• 2010

Purpose: The "golden hour" concept in trauma is pervasive despite little evidence to support it. This study addressed the association between prehospital time and in-hospital mortality in seriously injured abdominal trauma victims. Methods: A retrospective study was conducted over a three-year period from 2006 to 2008. We analyzed trauma victims with abdominal injuries who underwent an emergency laparotomy in a local emergency center located in a city with a population of 2,500,000. According to the 'golden hour' oncept, we separated the trauma victims into two groups (Gourp 1: prehospital time ${\leq}$ 1 hour, Group 2: prehospital time > 1hour) and investigated several factors, such as time, process, and outcome. Results: During the period from January 2006 to December 2008 139 trauma victims underwent an emergency laparotomy, and 89 of them were enrolled in this study. Between the two groups, emergency department (ED) access, transportation, and injury mechanism showed statistically meaningful differences, but no statistically meaningful differences were observed in various measures of the outcome, such as length of hospital stay, length of Intensive Care Unit stay, and mortality. In a univariate logistic regression study, age (odds ratio [OR]: 1.101; 95% confidence interval [CI]: 1.026 to 1.182), Revised Trauma Score (RTS) (OR: 0.444; 95% CI 0.278 to 0.710), hemoglobin (OR: 0.749; 95% CI: 0.585 to 0.960), and creatinine (OR: 24.584; 95% CI: 2.019 to 299.364) were significant prognostic factors, but prehospital time was not. In a multivariate logistic regression study, age and RTS were significant associated with mortality. Conclusion: In this study, we found no association between prehospital time and mortality among abdominal trauma patient who underwent an emergency laparotomy. We suggest that in our current out-of-hospital and emergency care system, until arrival at the hospital time may be less crucial for trauma victims than once thought.

• Journal of Gastric Cancer
• /
• v.18 no.4
• /
• pp.392-399
• /
• 2018

Purpose: To determine the incidence of incisional hernia (IH) in mini-laparotomy wounds and analyze the risk factors of IH following laparoscopic distal gastrectomy in patients with gastric cancer. Materials and Methods: A total of 565 patients who underwent laparoscopic distal gastrectomy for gastric cancer at Dong-A University Hospital, Busan, South Korea, between June 2010 and December 2015, were enrolled. IH was diagnosed through physical examination or computed tomography imaging. Incidence rate and risk factors of IH were evaluated through a long-term follow-up. Results: Of those enrolled, 16 patients (2.8%) developed IH. The median duration of follow-up was 58 months (range, 25-90 months). Of the 16 patients with IH, 15 (93.7%) were diagnosed within 12 months postoperatively. Multivariate analysis showed that female sex (odds ratio [OR], 3.869; 95% confidence interval [CI], 1.325-11.296), higher body mass index (BMI; OR, 1.229; 95% CI, 1.048-1.422), and presence of comorbidity (OR, 3.806; 95% CI, 1.212-11.948) were significant risk factors of IH. The vast majority of IH cases (15/16 patients, 93.7%) developed in the totally laparoscopic distal gastrectomy (TLDG) group. However, the type of surgery (i.e., TLDG or laparoscopy-assisted distal gastrectomy) did not significantly affect the development of IH (P=0.060). Conclusions: A median follow-up of 58 months showed that the overall incidence of IH in mini-laparotomy wounds was 2.8%. Multivariate analysis showed that female sex, higher BMI, and presence of comorbidity were significant risk factors of IH. Thus, surgeons should monitor the closure of mini-laparotomy wounds in patients with risk factors of IH undergoing laparoscopic distal gastrectomy.

• Journal of Trauma and Injury
• /
• v.19 no.2
• /
• pp.135-142
• /
• 2006

Purpose: We planned to determine the diagnostic capability of focused assessment with sonography for trauma (FAST) in cases of blunt abdominal injury (BAI). Methods: A retrospective analysis of FAST sheets was performed from April 2002 to December 2004. During the study period, 135 BAI patients were evaluated with FAST at the Emergency Department of Bundang CHA Hospital. Of this group, twenty-eight patients were excluded, leaving 107 patients for analysis. Abdomen CT (computerized tomography) or exploratory laparotomy confirmed the presence of hemoperitoneum. At the secondary survey, patients underwent a three-view FAST examination (LogicQ; General Electric, Waukesha, USA) by an emergency physician, followed within 2 hours by an abdomen CT or exploratory laparotomy. The FAST examination was considered positive if it demonstrated evidence of free intra-abdominal fluid. Results: There were 45 true-positive FAST examination, 57 true-negatives, 1 false-positive, and 4 false negatives (sensitivity 91.8%, specificity 98.3%, positive predictive value 97.8%, negative predictive value 93.4%). The area under the ROC curve was 0.951 for the FAST examination. Conclusion: FAST is a highly reliable method for screening patients suspected of having BAI for the presence or absence of hemoperitoneum.