Postoperative complications in abdominal surgery have a high incidence in developing countries’ hospitals, thus increasing the rate of their morbimortality. The aim of this work was to determine the frequency of early postoperative complications in abdominal surgery, their indications for operation, the types of postoperative complications, and their prognosis at University Clinics of Lubumbashi.
Patients and Methods: This is a descriptive cross-sectional observational study with retrospective data collection from January 1, 2018 to December 31, 2019 including all patients operated on in the abdominal surgery department of the University Clinics of Lubumbashi and having presented complications within 30 postoperative days.
Results: The frequency of early postoperative complicationsin abdominal surgery was 32.2%. The sex ratio M / F was 2.5 and the mean age was 31.5 ± 0.6. Emergency was the mode of admission in 80% of cases with a mean admission time of 17.2 ± 0.5. In this study, 71.42% of patients were classified ASA III. The mean time to surgical management was 36.5 ± 1.7 hours.Asthenia (62.9%) and abdominal pain (80%) were the most dominant functional signs. Suppuration of the wound (30.5%), abdominal distension (26.6%) and flow of stercoral fluid through the wall (23.8%) were the most dominant physical signs. The antibiogram on wound secretion (19%), imaging combining the chest x-ray (20%), the abdomen without preparation (27.6%) and the abdominal ultrasound (65.7%) are additional examinations which were more practiced. The post-operative complications were grade III in 95.24% of cases (n = 100) according to the Clavien-Dindo classification. The initial indications for surgery were more dominated by acute peritonitis (60%), followed by mechanical intestinal obstruction (16%). The duration of surgery was> 2 hours in 81% of cases and in 58.09% of cases the initial intervention was performed by a specialist. The mean time to resumption of oral feeding was 3.4 ± 0.6 days (Extreme: 12 hours and 192 hours). POC occurred within 5 days of surgery (59.04%).
Surgical complications were more dominant (80%), made up of postoperative peritonitis (33.33%), digestive fistulas (19.5%), surgical site infection (16.7%), post-operative intestinal obstruction (13.1%) and evisceration in 6%% of cases. The majority of post-operative complications (52.4%) had undergone relaparotomy, and the outcome was good in 69.5% of cases (n = 73/105), with a mortality rate of 30.4% of cases (n = 32/105). The mean length of hospital stay was 27.4 ± 0.5 days.
Conclusion: Postoperative complications are frequent at University Clinics of Lubumbashi and dominated by infection, postoperative peritonitis and digestive fistulas. The implementation of well-coded management algorithms could reduce this incidence.