Causes of unplanned reoperation in pediatric patients undergoing elective digestive tract surgery and the prognosis
10.3760/cma.j.cn113855-20220226-00110
- VernacularTitle:儿童消化道择期手术后非计划再手术原因分析及其预后
- Author:
Zengmeng WANG
1
;
Yajun CHEN
;
Chunhui PENG
;
Wenbo PANG
;
Dongyang WU
;
Kai WANG
Author Information
1. 首都医科大学附属北京儿童医院普外科 国家儿童医学中心，北京 100045
- Keywords:
Reoperation;
Digestive system surgical procedures;
Child;
Prognosis
- From:
Chinese Journal of General Surgery
2022;37(12):925-929
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the causes of unplanned reoperation in pediatric patients after elective digestive tract surgery and the prognosis.Methods:Medical records were reviewed from pediatric patients undergoing unplanned reoperation after elective digestive tract surgery at our department from Jan 2012 to Dec 2019. Primary diagnoses, procedures and levels of index surgeries, causes and procedures of unplanned reoperations, and patients' prognosis were analyzed.Results:There were 39 cases, and the primary diagnoses included biliary disease, anal and colorectal disease, and intestinal disease. There were 4 (10%) cases of level Ⅱ surgeries,and 35 (90%) cases of level Ⅲ&Ⅳ surgeries. The index surgical procedures included 19 (49%) biliary-intestinal procedures, 11 (28%) simple intestinal procedures, and 9 (23%) anal and colorectal procedures. The direct causes of unplanned reoperation included 10 (26%) anastomotic leakages, 8 (20%) adhesive intestinal obstructions, 5 (13%) postoperative intussusceptions, 5 (13%) incisional complications (infection, dehiscence and incisional hernia), 3 (8%) postoperative hemorrhages and 8 (20%) miscellaneous (iatrogenic injury and surgical misjudgment). Patients' prognosis included 24 (62%) full recoveries, 9 (23%) further operations, and 5 (13%) deaths, and 1 (3%) short bowel syndrome.Conclusions:Most pediatric unplanned reoperations after elective digestive tract surgery occur in complex surgical procedures. The most common causes of unplanned reoperation are anastomotic leakage, adhesive intestinal obstruction. Unplanned reoperations are often prone to adverse effects on prognosis.
