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On-Demand Surgery for Peritonitis Less Costly

Similar morbidity, mortality as planned relaparotomy but less costly

TUESDAY, Aug. 21 (HealthDay News) -- In patients with severe secondary peritonitis, on-demand relaparotomy has similar rates of morbidity and mortality as planned relaparotomy but with shorter hospital stays and lower medical costs, according to a report in the Aug. 22/29 issue of the Journal of the American Medical Association.

Marja A. Boermeester, M.D., Ph.D., from the Academic Medical Center in Amsterdam, the Netherlands, and colleagues randomized 232 patients with severe secondary peritonitis to on-demand or planned relaparotomy.

The researchers found that 12-month morbidity and mortality were similar in the on-demand and planned groups (57 versus 65 percent). Forty-two percent of the on-demand group and 94 percent of the planned group had a relaparotomy. The on-demand group had significantly shorter median stays in the intensive care unit, shorter median hospital stays, and 23 percent lower direct medical costs per patient.

"The results are consistent with the notion that an on-demand relaparotomy approach may improve outcomes and save health care resources," David R. Flum, M.D., and Farhood Farjah, M.D., from the University of Washington in Seattle, write in an accompanying editorial.

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