Reinterventions after abdominal surgery at panzi general referral hospital in bukavu, democratic republic of the congo

Aim: This study aimed to identify the epidemiological aspects, analyzing indications, management and outcomes of reoperations in abdominal surgery, at the PanziGeneral Referral Hospital (GRH) in DRC.

Patient and methods: We carried out a retrospective study of 67 patients re-operated at the PanziGRH, of whom 38 have been transferred from other medical institutionsand 29 surgical resumptions from the 946 cases initially operated at PanziGRH, from January 1st, 2012 to December 31st 2015.All abdominal surgical resumptions performed during the study period were selected. Variables investigated were indications of initial laparotomy, symptoms, reoperation indications, intraoperative diagnosis, and postoperative follow-up.

Results: Frequency of surgical resumption for cases initially treated at PanziGRH was 3.1% (29 out of 946 cases of abdominal surgery).The female sex was more touched with 37 cases (55.2%) and with a sex ratio of 1.2. The most affected age group is between 21 and 30 years oldin29.9%. Acute peritonitis of various causes was the most frequent indication of initial diagnosis with 36 cases, (53.6%), obstetrical cause (uterine rupture, VA, etc.) with 11 cases (16.4%).Enteral fistula was the main indication of surgical resumption with 43 cases (64.2%).The number of surgical resumption was 3 to 5 times in 45 cases (67.1%).58.8% of patients had a hospital stay between 41to 60 days and 17 patients died (25.4%) mainly due to septic shock in 58.8%.

Conclusion: Reoperations after abdominal surgery are frequent in our working conditions. Most patients are referred from other medical facilities. The organization of comprehensive medical and surgical care services, including resuscitation, are a necessity to reduce the abdominal reoperation rate.