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2016 ; 22
(ä): 2900-4
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Bogota Bag Use in Planned Re-Laparotomies
#MMPMID27530309
Karakose O
; Fatih Benzin M
; Pülat H
; Zafer Sabuncuoglu M
; Eken H
; Zihni I
; Barut I
Med Sci Monit
2016[Aug]; 22
(ä): 2900-4
PMID27530309
show ga
BACKGROUND Planned re-laparotomies are a series of surgical interventions that
are rarely used and have a high mortality rate. The aim of this study was to
investigate the factors affecting mortality and the effectiveness of the use of
the Bogota bag for temporary closure of the abdomen in patients for whom
re-laparotomy was planned. MATERIAL AND METHODS A retrospective examination was
made of data of patients in whom a Bogota bag was used in planned re-laparotomies
for various reasons in the General Surgery Department of Suleyman Demirel
University Medical Faculty between June 2008 and April 2014. RESULTS Bogota bags
were used in a total of 38 patients, comprising 23 (60.5%) males and 15 (39.5%)
females, with a mean age of 58.94±17.89 years. The mean period of hospitalization
was 14.5 days (range, 1-143 days) and the mean number of operations during that
time was 3 (range, 1-11). The mean duration of intensive care unit stay was 6
days (range, 1-143 days). Malignancy was determined in 8 patients (21.1%).
Indications were intra-abdominal sepsis in 23 patients (60.5%), mesenteric
vascular disease in 10 patients (26.3%), and packing was required in 5 patients
(13.2%). Mortality developed in 25 patients (65.8%). A significant relationship
was determined between mortality and a diagnosis of mesenteric artery ischemia
(p: 0.035). The mortality rate was 56% (n: 13) in patients diagnosed with
intra-abdominal sepsis. A relationship was determined between mortality and age
(p: 0.015), duration of hospital stay (p: 0.007), need for cardiac inotrope (p:
0.01), and need for mechanical ventilation (p: 0.01). The mean Apache II score
was 26.4±5 for patients who died and 15.8±5.2 for surviving patients (p<0.001).
In 5 (38.4%) of the 13 surviving patients, primary repair was applied to the
abdomen, and in the remaining 8 patients abdominal wall repair was performed
using dual mesh. CONCLUSIONS In patients in whom a Bogota bag was used, which is
a cheap and easy method for temporary closure of the abdomen, the high mortality
rates seen are related to diagnosis, Apache II score, age, and organ failure.
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