{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:23:10Z","timestamp":1789471390673,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2005,4,14]],"date-time":"2005-04-14T00:00:00Z","timestamp":1113436800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2005,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Second\u2010look laparotomy is one of the mainstays of surgical treatment of acute mesenteric ischemia (AMI). The aim of this study was to analyze its role in the survival of patients with infarcted gangrenous bowel resulting from AMI. A retrospective chart review of all patients admitted over the study period was undertaken. The study population consisted of 41 patients with clinical evidence of peritonitis and gangrenous, perforated bowel on surgical exploration. Outcome was compared among patients who underwent second\u2010look laparotomy and those who did not. Fifteen patients with an American Society of Anesthesiologists (ASA) score of less than 4 underwent second\u2010look laparotomy. Six patients had residual necrotic bowel that required additional resection. Only one (17%) of them survived. Of the nine remaining patients, who had no evidence of necrosis, only two survived (22%). Overall survival in this group was 20%. Twenty\u2010six patients were managed without second\u2010look laparotomy. Nine of them, with an ASA score of 4\u20135, died soon after the operation. The decision not to operate on the remaining 17 patients with an ASA score &lt;4 was made by an experienced surgeon. Eleven of those patients (65%) survived. Overall survival in the non\u2010second\u2010look group was 42%. Excluding the early deaths, the survival in the non re\u2010explored group was significantly higher than in the second\u2010look group (65% vs. 20%, <jats:italic>p<\/jats:italic> = 0.011). A selective approach to the surgical treatment of acute mesenteric ischemia based on the sound clinical judgment of an experienced surgeon may be as appropriate as its universal application.<\/jats:p>","DOI":"10.1007\/s00268-005-7380-5","type":"journal-article","created":{"date-parts":[[2005,4,12]],"date-time":"2005-04-12T14:13:21Z","timestamp":1113315201000},"page":"645-648","source":"Crossref","is-referenced-by-count":34,"title":["Does a Second\u2010look Operation Improve Survival in Patients with Peritonitis due to Acute Mesenteric Ischemia? A Five\u2010year Retrospective Experience"],"prefix":"10.1002","volume":"29","author":[{"given":"Oleg","family":"Kaminsky","sequence":"first","affiliation":[{"name":"Department of Surgery Rabin Medical Center Beilinson Campus 49100 Petah Tiqva Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igal","family":"Yampolski","sequence":"additional","affiliation":[{"name":"Department of Surgery Rabin Medical Center Beilinson Campus 49100 Petah Tiqva Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Aranovich","sequence":"additional","affiliation":[{"name":"Department of Surgery Rabin Medical Center Beilinson Campus 49100 Petah Tiqva Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehud","family":"Gnessin","sequence":"additional","affiliation":[{"name":"Department of Surgery Rabin Medical Center Beilinson Campus 49100 Petah Tiqva Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franklin","family":"Greif","sequence":"additional","affiliation":[{"name":"Department of Surgery Rabin Medical Center Beilinson Campus 49100 Petah Tiqva Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,4,14]]},"reference":[{"key":"e_1_2_5_2_2","first-page":"354","article-title":"Intestinal ischemia","volume":"54","author":"Cokkinis AJ.","year":"1961","journal-title":"Proc. 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