Trakia Journal of Sciences, Vol. 8, No. 1, 2010
87
Trakia Journal of Sciences, Vol. 8, No. 1, pp 87-90, 2010
Copyright © 2009 Trakia University
Available online at:
http://www.uni-sz.bg
ISSN 1313-7050 (print)
ISSN 1313-3551 (online)
Mini-Review
RELAPAROTOMY-DEFINITION AND ATTEMPT FOR
A NEW CLINICAL CLASSIFICATION
Y. Yovtchev*, St. Nicolov, N. Stanilov, Iv. Ovcharov, Al. Petrov
Department of Surgical Diseases, University Hospital –Stara Zagora
ABSTRACT
In the last years as a result of heaping of clinical database connected with adequately and timely
operative treatment in patents with postoperative complications existed а series of questions. First of
all it was connected with the way of classification on the reasons that demanded new laparotomies. Аt
the moment the offered classification for laparotomy shows our understanding for the leading causal
connection to a certain degree. Although its priorities, there are some contradictions in combined
cases.
This makes us doing a review of the adopted classification and to try to bring her clinical meaning up
to date. We hope it would help and facilitate the daily surgical work if, of course, it will be good
received in medical surgical community.
Key words: re-laparotomy, classification
Under the name of the relaparotomy we
understand doing of repeated laparotomy after
run through a stomach operation before
that.This term has a Greek origin and it has
three parts in it re-repeated, lapara-stomach,
tomie-cut up, i.e. a repeated exploratory
operation of the stomach cavity.
Some authors try to put the relaparotomy
in a straight relation with the first operation.
Тhey explain the surgical treatment of the
complications, which are arisen after the
operation of the abdominal organs, or the part
of this treatment when it is not factually
finished. It exists some misunderstanding
about this definition. Thus, the relaparotomy
can be done and for removing some
diagnostically and tactical mistakes from the
first operation and also in a new disease.
According to (1) under the relaparotomy we
understand “a new opening of the abdominal
cavity in postoperative period, independently
of the reason of the operation. Of course, this
definition is also not a completely clear about
what is this a relaparotomy, because it doesn’t
___________________________
* Correspondence to: Y. Yovtchev, Department of
Surgical Diseases, University Hospital –Stara
Zagora, E-mail: yovtchev@abv.bg
point the duration of postoperative period and
it doesn’t fix the time after the first operation.
Mamich V. I. and co. (2) offers in the
definition for a relaparotomy to consist the
time of hospitality in surgical clinics – “аn
interference, which accomplish in the time of
hospitality in a surgical ward, after the first
operation”. The reason that the patents are kept
in the ward for different periods of time, often
for months, is unclear and inaccurate in many
cases.
It doesn’t exist yet an exact distinction of
the terms “repeated operation” and
“relaparotomy”. The world famous surgeons
like (3, 4), even they mix the term
”relaparotomy” with a reoperation in the early
postoperative period. These authors think that
reoperation as “early” until 14th and “lately”
after 14
th
from the first abdominal operation.
They define as “lately” one and the reoperation
which is done 30 days after the first one on
purpose closure of intestinal fissures,
colostomies or reconstructive operations of
gastrointestinal or urogenital tract. Аs itself
the term ”relaparotomy” means the next
intervention in the abdominal cavity, so that
the reoperation is combined definition and it
can be also used for other types of the
repeated operations in the stomach.