Background
Early diagnosis and emergent surgical treatment of perforation peritonitis remain the mainstay of treatment. The purpose of study was to indentify the effect of early surgery on postoperative outcomes in patients with perforation peritonitis.
Material and Methods
A retrospective medical report of 200 patients who underwent exploratory laparotomy and proceed for perforation peritonitis from July 2014 to June 2016 was evaluated. Patients were divided into two groups based on the time of surgery i.e: Early (< 0.05), and had significantly higher median time to resumption of normal diet (5.0 [0–15] vs. 2.8 [1–5] days, P < 0.05) and length of ICU stay (8 [1-26] vs. 4 [1-9] days, …show more content…
Keywords
Early surgery, Perforation , Peritonitis, Complication, Outcome
1 Introduction
Gastrointestinal perforations constitute one of the commonest surgical emergency encountered by surgeons (1,2). Management of these patients continues to be highly demanding despite the advances made in diagnosis and surgical therapy. Perforation peritonitis is highly fatal with a reported death rate of up to 56% (1–4). Many reports have described surgical intervention within 8–24 h after the arrival of patient at the emergency department decreases death rates (5). The general belief of surgeons is that the earlier one operates, the better the outcome. However, only few studies have reported the issue of time to intervention and how early time has not been cosidered. In our day to day work , our experience is that the sooner we do surgery and close the perforation, the better the postoperative outcome.Our patients with perforation peritonitis got operated within the first 2–4 h after their arrival or diagnosis. However, we could not find any large study that demonstrated operations in the first 2–4 h, probably because most of the patients need aggressive resuscitation before the surgery. We thought to find out the effect of early surgery on patients postoperative outcomes .We aimed that operating within the first 6 h after diagnosis of perforation peritonitis would improve outcomes outcomes in resource poor setting of developing