Planned relaparotomy vs relaparotomy on demand in the treatment of @entity1320 . The XXXX Study Group of the Surgical Infection Society-Europe.

@entity1 @entity881 @entity1320 @entity166 @entity298
OBJECTIVE: To define the role of planned relaparotomy (PR) in the treatment of intraperitoneal infection, compared with that of relaparotomy on demand (RD). DESIGN: Case-control study on the basis of a prospective multicenter cohort analytic study. Statistical evaluation was done by the McNemar test for qualitative data and the Wilcoxon matched-pairs signed rank test for qualitative data. SETTING: Eighteen hospitals of different care levels in Austria, Germany, and Switzerland. @entity1 : Thirty-eight of 42 @entity1 with @entity1320 who underwent PR were matched for APACHE II (Acute Physiology and Chronic Health Evaluation II) score, age, cause of infection, site of origin of @entity298 , and the ability of the surgeon to securely eliminate the source of infection with 38 @entity1 taken from a cohort of 278 undergoing RD. INTERVENTIONS: Planned relaparotomy was defined as at least one relaparotomy decided on at the time of the first surgical intervention; RD, relaparotomy indicated by clinical findings. MAIN OUTCOME MEASURES: Mortality and incidence of postoperative @entity881 and @entity166 . RESULTS: There was no significant difference in mortality between @entity1 treated with PR (21%) or RD (13%). Postoperative @entity881 as defined by a Goris score of more than 5 was more frequent in the group of @entity1 undergoing PR (50%), compared with the group undergoing RD (24%) (P = .01), as were @entity166 (68% vs 39% [P = .01]). @entity166 were due to more frequent suture leaks (16% vs 0% [P = .05]), recurrent @entity1320 (16% vs 0% [P = .05]), and septecemia (45% vs 18% [P = .05]) in the PR vs the RD groups. The incidence of other complications was not different in the two groups. CONCLUSIONS: Until larger prospective studies are available, the indication for PR should be evaluated with caution.
