This prospective study was designed to evaluate the role of intro-abdominal pressure (IAP)
measurement during the early postoperative period as a criterion of the need for re-exploration. The
study comprised 90 patients: 60(66.7%,) males and 30 (33.3%1 females, with mean age 45.15+11.9. All
patients were assigned to undergo exploratory laparotomy for acute abdomen for various indications.
Each patient underwent single preoperative and eight-hourly postoperative serial JAR measurements
for a period of 72 hours via two-ways indwelling Foley 's catheter. 12 patients underwent
relaparatomy, 10 had a significant increase in JAR during 1st 48 hours postoperatively followed by
slow or even no decline during the next 24hours. This rise preceded the day of operative confirmation
by 3+1.5 days. whereas the other 2 patients showed slow decline over 1st 72 hours postoperatively. 78
patients had uneventfill course, 18 patients had mild increase in JAR levels during 1st day followed by
decline over next 2 days. Whereas, 60 patients had a decline in JAR levels during the 1st 72 hours
postoperatively. The specificity of the method was 76.9 %, sensitivity 83.3 %, negative predictive value
96.8 %, positive predictive value 35.7 %, with overall accuracy of 77.8 %. This study supports the role
of JAR as a relevant marker for deciding the need for relaparotomy, as a part of the on-demand
approach. |
