Journal de la Faculté de Médecine
Volume 2, Numéro 5, Pages 385-391
2018-12-30
Etude Comparative Entre Contexte D’urgence Et Contexte De Chirurgie Programmée De L’intervention Initiale Des Péritonites Postopératoires
Auteurs : Boukrissa Merouane . Brahmi-seddiki Khadidja . Benhamed Mohamed Amine .
Résumé
Abstract Introduction - The objective of this study is to highlight the different epidemiological, clinico-prognostic and therapeutic profiles of postoperative peritonitis depending on the initial context, emergency or programmed surgery, initial intervention. Materials and methods - This is a retrospective and prospective study that gathered 127 patients operated for postoperative peritonitis in the ORAN surgical emergency department. This study is retrospective from September 2011 to September 2015 and prospective from October 2015 to December 2017. The initial intervention in an emergency context involved 83 patients (65.4%) compared to 44 patients (34.6%) initially operated in a planned surgery setting. Results - The average age of patients in the Emergency Context Group [CEU] was 46.6 years versus 49.9 years for patients undergoing surgery in the context of programmed surgery [GCP]. A male predominance of 59.0% was observed in the [GCU] versus 52.2% in the [GCP]. The degree of sepsis of the interventions, according to the classification of Altemeier had shown that the initial interventions (classes III / contaminated and IV / dirty) represented respectively 90,2% and 100% for the [GCU], and 9,7% and 0% for the [GCP]. The state of shock was found in 26 patients, 17 of whom had been operated initially in emergency context (65%). The mortality was 31.3% in the [GCU] against 27.2% in the [GCP]. P = 0.635. Conclusion - This comparative study made it possible to highlight the different epidemiological, diagnostic and therapeutic characteristics distinguishing the two groups of patients operated according to the emergency nature or not of the primary intervention.
Mots clés
Postoperative peritonitis, emergency context, surgical revision, CHU Oran.
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