Morbidity and mortality after gut resection and anastomosis Western Kenya

Abstract

The objective of this study was to determine the morbidity and mortality after gut resection and anastomosis in a tertiary centre in Kenya. To do this a retrospective, hospital-based study, cohort study of patients who underwent resection and anastomosis in the period 2002 - 2006, both years inclusive. The general surgical wards of Moi Teaching and Referral Hospital (MTRH), a 750 teaching and referral hospital in the Western region of Kenya was used for the study. Two hundred and twenty patients of all ages underwent gut resection and anastomosis for various reasons over the period of study. The primary outcome measures were morbidity and mortality in this group of patients. Morbidity was considered in terms of postoperative complications and hospital length stay. The secondary outcome measures were the patient demography, vital signs at admission and delay in surgery. The morbidity rate was 22.7 % while the mortality rate was 15.9 %. The principal indicators of morbidity were the intra-abdominal pathology, the duration from onset of symptoms to surgery and the type of anastomosis. The patient’s age, type of anastomosis and postoperative complications were key determinants of mortality. In conclusion, pre operative resuscitation in patients who underwent gut resection and anastomosis influenced morbidity and mortality. Delay in surgery and the type of anastomosis done were determinants of post-operative complications which in turn influenced the outcome of treatment.