A STUDY OF POST-OPERATIVE PULMONARY COMPLICATIONS IN PATIENTS UNDERGOING EMERGENCY EXPLORATORY LAPAROTOMY FOR ACUTE ABDOMINAL CONDITIONS: A PROSPECTIVE OBSERVATIONAL STUDY.

Background: Emergency laparotomy is associated with high rates of mortality and postoperative complications, as well as prolonged hospital stay. It remains uncertain when death and complications occur. The present research is aimed to study the incidence of post-operative pulmonary complications after emergency exploratory laparotomy. A cross-sectional observational study on 60 pa Methodology: tients was carried out in department of General Surgery at tertiary care institute on patients who underwent emergency exploratory laparotomy for acute abdominal conditions under General Anaesthesia for a duration of 18 months. Post-operatively pulmonary complications were assessed. Appropriate statistical tests were applied for statistical analysis. P ≤ 0.05 at 95% condence interval was considered as statistically signicant. There Results: were 70% in 51-60 years. Male patients were 40% and female patients were 60%. ASA 1, 2, 3, 4 and 5 constituted about 11.6%, 41.6%, 35%, 8.3% and 3.3% of the study population respectively. Duration of surgery lasted for 2 hours in 23.3%, 2-5 hours in 5% and 3 hours in 71.6% of the patients. There were 33% of smokers, 21.6% had diabetes mellitus, 23.3% hypertension, 20% had history of lung disease, 21.6% had history of cardiac disease and 13.3% had history of respiratory infection. Nasogastric tube was used after laparotomy in 51.6% of the subjects. Incentive spirometry was done in 90% of the subjects. Upper incisions were done in 28.3% of cases, upper/lower and lower were done in rest 33.3% and 38.3% of cases respectively. Post laparotomy complications were seen in 10% of the subjects. Pneumonia, atelectasis, bronchitis and pleural effusion were seen in 50%, 16.6%, 16.6% and 16.6% of cases respectively. 83.3% of patients stayed in hospital for >7 days. Conclusion: The PPCs are higher in smokers, in patients with comorbid respiratory diseases, and with longer duration of surgery. PPCs increase the hospital, and ICU stay and mortality. Pneumonia is most common respiratory complication observed. Outcomes of laparotomies are multifactorial with high morbidity and mortality, leading to an escalation in hospital costs and prolonged illness which can be avoided if the factors involved are properly addressed.