KLÝNÝÐÝMÝZDE AÞAMALI ABDOMÝNAL ONARIM (STAR) UYGULAMALARI

STAGED ABDOMINAL REPAIR (STAR) PROCEDURES IN OUR CLlNIC

Aim: In this study we assessed the results of staged abdominal repair (STAR) applications in our clinic.
METHODS: Retrospective analysis ofsix cases who were operated by staged abdominal repair (STAR) between December 1998-1January 2002 were assessed according to operation indications, type of operation, presentation ofthe complications and mortality.
RESULTS: The initial operations for two ischemic bowel disease cases were right hemicolectomy + end ileostomy + mucous fistula and partial small bowel resection + right hemicolectomy + ileotransversostomy. The operative indications were fistula formation following strangulatedfemoral hernia, diverticular perforation, diverticulitis + massive lower gastrointestinal bleeding and abdominal ! gunshot trauma, and operations were right hemicolectomy + ileotransversostomy, subtotal colectomy + ileorectostomy + diverting ileostomy, subtotal colectomy + Hartmann procedure and primary repair of vena cava + distal pancreatectomy + left hemicolectomy+ Hartmann procedure respectively. Median hospital stay was 28 days. Two cases had pulmonary problems (pleural effiýsion and 1 atelectasis). Gunshot trauma patient died four days after the abdominal closure probably due to pulmonary emboli.
CONCLUTIONS: Relaparotomy decision may be made prior to the operation but the final decision is made per-operatively. Staged abdominal repair gives an opportunity for sufficient debridement and peritoneallavage and also gives a chance to evaluate the anastomosis sites..