[Scheduled reinterventions in the treatment of acute peritonitis].

UNLABELLED: This is a clinical series of 83 cases, admitted in the Surgical Department of Fundeni Hospital between 1988-1996 of severe acute peritonitis in which scheduled reoperations (at least one planned reoperation at 24-48 hours after the first operation) were performed. The main criteria for scheduled reoperations were; unresolved source of contamination, acute peritonitis older than 48 hours and the presence of multiple system organ failures. 63 cases (76%) were postoperative peritonitis. 203 planned reoperations were performed (minimum: 1, maximum: 10, mean: 2,4 reoperations per patient). In 12 cases (14,4%) a laparotomy "on demand" was necessary after the scheduled reoperations were stopped. The source of peritonitis was resolved in 61 cases (73,5%) and unresolved in 22 cases (26,5%). In 9 cases (10%) specific complications of the method (hemorrhages, fistulas) were encountered. The global mortality was 65,06%, with 55,73% mortality when the source of peritonitis was resolved and 90,9% mortality when the source was not resolved.

CONCLUSION: scheduled reoperations have to be reserved for the most severe cases of acute peritonitis in which the mortality after the "classical" methods of treatment is extremely high.