Navigation Links
One Surgery Often Enough for Peritonitis
Date:8/21/2007

Study questions usefulness of secondary procedures

TUESDAY, Aug. 21 (HealthDay News) -- Patients with a serious gastrointestinal infection known as peritonitis may not automatically need to undergo more operations beyond the first one, new research suggests.

In the United States, most surgeons choose to wait and see if they think patients need the extra surgery, said Dr. David Flum, a gastrointestinal surgeon at the University of Washington, who wrote a commentary about the study.

Until now, however, "there hasn't been a lot of evidence to guide that decision," he said.

The findings are published in the Aug. 22/29 issue of the Journal of the American Medical Association.

Peritonitis occurs when a hole develops in the intestines -- such as when the appendix bursts -- and allows bacteria to spill into the abdominal cavity, Flum said. Severe infection can result.

There's a high risk of death even after surgeons plug up the hole, he said, because bacteria remains and creates problems.

One approach has been to operate and then "keep taking them back to the operating room and washing out the abdominal cavity until they improve," Flum said. "Another strategy is to re-operate when the patient's body is giving you signs that it needs an operation."

In the new study, Dutch researchers at the Academic Medical Center, Amsterdam, examined the impact of each strategy on 225 patients. Only 42 percent of those in the "non-automatic-surgery" group actually went on to have a secondary operation, compared to 94 percent in the automatic-surgery group.

About a third of the patients in both groups died, and the researchers said there was no "significant difference" between their mortality rates.

However, patients who only underwent a second surgery when their doctors thought it necessary spent an average of seven days in intensive care versus 11 days for the other group. They also spent an average of 27 days in the hospital versus 35 days in the automatic-surgery cohort.

Meanwhile, "direct medical costs" were 23 percent less among those who didn't automatically have a subsequent surgery.

"It doesn't like look there's a huge difference in survival," Flum said. "But the approach with fewer operations and less cost would be the preferred one."

Dr. E. Patchen Dellinger, chief of the division of general surgery at the University of Washington, Seattle, said he hopes that questions about the validity of automatic re-operation are now settled.

"An area that could use study is how long antibiotics should be continued in the treatment of peritonitis," said Dellinger, who also wrote a journal commentary on the Dutch study. "Currently, I believe that many [peritonitis] patients get antibiotics for far longer than needed."

More information

There's more on peritonitis at the University of Maryland.



SOURCES: David R. Flum, M.D., associate professor, surgery and surgical outcomes and gastrointestinal surgeon, University of Washington, Seattle; E. Patchen Dellinger, M.D., professor and vice chairman, department of surgery, and chief, division of general surgery, University of Washington, Seattle; Aug. 22/29, 2007, Journal of the American Medical Association


'/>"/>
Copyright©2007 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. Bypass Heart Surgery Performed Without General Anesthesia
2. NEW ROBOTIC SURGERY ARM APPROVED BY FDA
3. Thyroid hormone treatment hastens recovery after cardiac surgery
4. Indian Prime Minister has successful Knee Replacement Surgery
5. Two doctors suspended for wrong brain surgery
6. Researchers urge caution in using ear tube surgery
7. Surgery made simple
8. Sweaty palms syndrome can be cured by surgery
9. Surviving surgery
10. Waking during surgery
11. Supplement helps cardiac surgery
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/12/2017)... ... ... IsoComforter, Inc. ( https://isocomforter.com ), one of the Nation’s premier ... of the shoulder pad. The shoulder pad provides optimal support and full contact ... using cold therapy. By utilizing ice and water that is circulated from an insulated ...
(Date:10/12/2017)... ... October 12, 2017 , ... ... leader in post-acute health care, have expanded their existing home health joint venture ... , AccentCare has been operating a joint venture home health company with Asante, ...
(Date:10/12/2017)... ... 12, 2017 , ... Dr. Parsa Mohebi, the Los Angeles ... to the newly revamped Cosmetic Town journal section, featuring articles written ... known as Follicular Unit Extraction (FUE). , Dr. Mohebi says “I ...
(Date:10/12/2017)... ... October 12, 2017 , ... Leading pediatric oncology experts at ... for the 49th Congress of the International Society of Paediatric Oncology (SIOP) ... Center for Cancer and Blood Disorders at Children’s National, and Stephen P. ...
(Date:10/12/2017)... GRAND RAPIDS, Mich. (PRWEB) , ... October 12, ... ... OnSite Wellness, has been named one of Michigan’s 2017 Best and Brightest in ... Best and Brightest in Wellness® awards program on Friday, Oct. 20 from 7:30 ...
Breaking Medicine News(10 mins):
(Date:10/2/2017)... COPENHAGEN, Denmark , Oct. 2, 2017 The ... tool in the struggle to reverse the tide of prescription ... plan for regulating their medicine intake and stepping down their ... is set to launch in December 2017; the first 100,000 ... access. Learn more at http://www.rebound-solution.com/ ...
(Date:9/27/2017)...  Commended for their devotion to personalized service, SMP Pharmacy ... one in the South Florida Business Journal,s 50 Fastest-Growing Companies, ... list, the national specialty pharmacy has found its niche.  To ... soon be honored by SFBJ as the 2017 Power Leader ... to receive his award in October, Bardisa said of the ...
(Date:9/25/2017)... , Sept. 25, 2017  EpiVax, Inc., a ... design, and immune-engineering today announced the launch of ... development of personalized therapeutic cancer vaccines. EpiVax has ... exclusive access to enabling technologies to the new ... will lead EpiVax Oncology as Chief Executive Officer. ...
Breaking Medicine Technology: