Analysis of postoperative complications that require a repeated procedure based on the material collected in 2009–2014 in the Department of Gynecologic Oncology of the Institute of Oncology in Warsaw

The paper presents the frequency of conducting relaparotomies and discusses indications for reoperations after primary gynecologic surgeries due to oncological diseases. Operations and reoperations were conducted in the Department of Gynecologic Oncology of Maria Skłodowska-Curie Institute of Oncology in Warsaw, Poland from 2009 to 2014. In total, 3,917 procedures due to reproductive organ neoplasms were conducted in the investigated period. The main indications were ovarian carcinoma, endometrial cancer and cervical cancer. Repeated urgent surgical interventions were needed in 116 patients, which constitutes 2.96% of all operated women. The frequency of repeated surgeries within the peritoneal cavity in gynecology, as reported in the literature, ranges from 1% to 4.7% and concerns primary indications resulting from non-malignant pathologies of the reproductive organs. The analysis involved early and urgent reoperations conducted within 48 hours after the primary procedure. Patients reoperated because of sudden progression of the diseases and those who underwent exploratory laparotomy within 60 days or who had a palliative surgery were excluded from the study. The main indication for a necessary urgent intervention was peritoneal bleeding. Other indications included: obstruction, peritonitis, bowel perforation, abdominal wall hematoma, intestinal anastomosis dehiscence and urinary complications. The mortality in the group of patients who required relaparotomy was 4.31%. An early diagnosis of complications requiring a repeated surgical intervention and implementation of appropriate management affect the outcome considerably and significantly decrease treatment-associated mortality.