Survey among surgeons on surgical treatment strategies for secondary peritonitis.
Dig Surg
; 21(5-6): 387-94; discussion 394-5, 2004.
Article
en En
| MEDLINE
| ID: mdl-15523182
ABSTRACT
BACKGROUND:
There is controversy about performing either a planned relaparotomy (PR) or relaparotomy on demand (ROD) in patients with secondary peritonitis. Subjective factors influencing surgeons in decision making for either surgical treatment strategy have never been studied.METHODS:
All 858 surgeons of the Association of Surgeons of The Netherlands were sent a survey with 16 case vignettes simulating peritonitis patients and evaluating the preference for PR or ROD.RESULTS:
Sixty-two percent of surgeons responded to the survey. Of the returned surveys, 407 were eligible for evaluation. The responding surgeons had a slight overall preference for the ROD strategy, as shown by the mean overall preference score of 5.2 (range 3.54-6.52, with a maximal score of 7). Gastrointestinal surgeons and surgeons working in regional and smaller hospitals were significantly more in favour of a ROD strategy than their counterparts. Factors significantly influencing the preference towards PR were ischaemia as aetiology and performing a primary anastomosis; as for ROD, it was small bowel as focus, local extent of contamination and the question whether abdominal closure was possible. However, there was a considerable variability in treatment decisions by surgeons.CONCLUSION:
The majority of responding surgeons would make a choice for a particular treatment strategy based on peritonitis and surgical treatment characteristics. There was a slight overall preference towards the ROD strategy despite the considerable variability per case vignette.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Peritonitis
/
Complicaciones Posoperatorias
/
Procedimientos Quirúrgicos del Sistema Digestivo
Tipo de estudio:
Etiology_studies
/
Prognostic_studies
Límite:
Adult
/
Aged
/
Humans
País/Región como asunto:
Europa
Idioma:
En
Revista:
Dig Surg
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2004
Tipo del documento:
Article
País de afiliación:
Países Bajos