{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:50:22Z","timestamp":1790740222167,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,5,30]],"date-time":"2018-05-30T00:00:00Z","timestamp":1527638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2018,5,30]],"date-time":"2018-05-30T00:00:00Z","timestamp":1527638400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Postoperative peritonitis (POP) following gastrointestinal surgery is associated with significant morbidity and mortality, with no clear management option proposed. The aim of this study was to report our surgical management of POP and identify pre\u2010 and perioperative risk factors for morbidity and mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients with POP undergoing relaparotomy in our department between January 2004 and December 2013 were included. Pre\u2010 and perioperative data were analyzed to identify predictors of morbidity and mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 191 patients required relaparotomy for POP, of which 16.8% required &gt;1 reinterventions. The commonest cause of POP was anastomotic leakage (66.5%) followed by perforation (20.9%). POP was mostly treated by anastomotic takedown (51.8%), suture with derivative stoma (11.5%), enteral resection and stoma (12%), drainage of the leak (8.9%), stoma on perforation (8.4%), duodenal intubation (7.3%) or intubation of the leak (3.1%). The overall mortality rate was 14%, of which 40% died within the first 48 h. Major complications (Dindo\u2013Clavien &gt;\u20092) were seen in 47% of the cohort. Stoma formation occurred in 81.6% of patients following relaparotomy. Independent risk factors for mortality were: ASA\u2009&gt;\u20092 (OR\u2009=\u20092.75, 95% CI\u2009=\u20091.07\u20137.62, <jats:italic>p<\/jats:italic>\u2009=\u20090.037), multiorgan failure (MOF) (OR\u2009=\u20095.22, 95% CI\u2009=\u20092.11\u201313.5, <jats:italic>p<\/jats:italic>\u2009=\u20090.0037), perioperative transfusion (OR\u2009=\u20092.7, 95% CI\u2009=\u20091.05\u20137.47, <jats:italic>p<\/jats:italic>\u2009=\u20090.04) and upper GI origin (OR\u2009=\u20093.55, 95% CI\u2009=\u20091.32\u20139.56, <jats:italic>p<\/jats:italic>\u2009=\u20090.013). Independent risk factors for morbidity were: MOF (OR\u2009=\u20092.74, 95% CI\u2009=\u20091.26\u20136.19, <jats:italic>p<\/jats:italic>\u2009=\u20090.013), upper GI origin (OR\u2009=\u20093.74, 95% CI\u2009=\u20091.59\u20139.44, <jats:italic>p<\/jats:italic>\u2009=\u20090.0034) and delayed extubation (OR\u2009=\u20090.27, 95% CI\u2009=\u20090.14\u20130.55, <jats:italic>p<\/jats:italic>\u2009=\u20090.0027).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Mortality following POP remains a significant issue; however, it is decreasing due to effective and aggressive surgical intervention. Predictors of poor outcomes will help tailor management options.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-018-4687-6","type":"journal-article","created":{"date-parts":[[2018,5,30]],"date-time":"2018-05-30T17:40:59Z","timestamp":1527702059000},"page":"3589-3598","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Postoperative Peritonitis After Digestive Tract Surgery: Surgical Management and Risk Factors for Morbidity and Mortality, a Cohort of 191\u00a0Patients"],"prefix":"10.1002","volume":"42","author":[{"given":"Thierry","family":"Bensignor","sequence":"first","affiliation":[{"name":"Department of General and Digestive Surgery, H\u00f4pital Saint\u2010Antoine, Assistance Publique H\u00f4pitaux de Paris Sorbonne Universit\u00e9 184 rue du Faubourg Saint\u2010Antoine 75012 Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9r\u00e9mie H.","family":"Lefevre","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, H\u00f4pital Saint\u2010Antoine, Assistance Publique H\u00f4pitaux de Paris Sorbonne Universit\u00e9 184 rue du Faubourg Saint\u2010Antoine 75012 Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Creavin","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery St Vincent\u2019s University Hospital Elm Park Dublin 4 Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najim","family":"Chafai","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, H\u00f4pital Saint\u2010Antoine, Assistance Publique H\u00f4pitaux de Paris Sorbonne Universit\u00e9 184 rue du Faubourg Saint\u2010Antoine 75012 Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Lescot","sequence":"additional","affiliation":[{"name":"Department of Surgical Intensive Care, H\u00f4pital Saint\u2010Antoine, Assistance Publique H\u00f4pitaux de Paris Sorbonne Universit\u00e9 75012 Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Th\u00e9vy","family":"Hor","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, H\u00f4pital Saint\u2010Antoine, Assistance Publique H\u00f4pitaux de Paris Sorbonne Universit\u00e9 184 rue du Faubourg Saint\u2010Antoine 75012 Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clotilde","family":"Debove","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, H\u00f4pital Saint\u2010Antoine, Assistance Publique H\u00f4pitaux de Paris Sorbonne Universit\u00e9 184 rue du Faubourg Saint\u2010Antoine 75012 Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Paye","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, H\u00f4pital Saint\u2010Antoine, Assistance Publique H\u00f4pitaux de Paris Sorbonne Universit\u00e9 184 rue du Faubourg Saint\u2010Antoine 75012 Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Balladur","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, H\u00f4pital Saint\u2010Antoine, Assistance Publique H\u00f4pitaux de Paris Sorbonne Universit\u00e9 184 rue du Faubourg Saint\u2010Antoine 75012 Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Tiret","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, H\u00f4pital Saint\u2010Antoine, Assistance Publique H\u00f4pitaux de Paris Sorbonne Universit\u00e9 184 rue du Faubourg Saint\u2010Antoine 75012 Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yann","family":"Parc","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, H\u00f4pital Saint\u2010Antoine, Assistance Publique H\u00f4pitaux de Paris Sorbonne Universit\u00e9 184 rue du Faubourg Saint\u2010Antoine 75012 Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,5,30]]},"reference":[{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00423\u2010009\u20100538\u20100"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11605\u2010008\u20100515\u2010x"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010002\u20106705\u2010x"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc7931"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/23.3.486"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.1086\/323333"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2014.11.002"},{"key":"e_1_2_8_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10120\u2010014\u20100445\u20100"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000201889.39443.D2"},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002689910007"},{"key":"e_1_2_8_12_2","first-page":"84","article-title":"The Mannheim peritonitis index. An instrument for the intraoperative prognosis of peritonitis","volume":"58","author":"Linder MM","year":"1987","journal-title":"Chirurg"},{"key":"e_1_2_8_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_8_14_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365\u20102168.1999.01205.x"},{"key":"e_1_2_8_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jviscsurg.2013.03.014"},{"key":"e_1_2_8_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02235565"},{"key":"e_1_2_8_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000053525.49267.77"},{"key":"e_1_2_8_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.137.3.296"},{"key":"e_1_2_8_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010012\u20102426\u2010x"},{"key":"e_1_2_8_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9388"},{"key":"e_1_2_8_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246\u2010198510000\u201000009"},{"key":"e_1_2_8_22_2","doi-asserted-by":"publisher","DOI":"10.5492\/wjccm.v6.i1.48"},{"key":"e_1_2_8_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31824485c4"},{"key":"e_1_2_8_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3182054d06"},{"key":"e_1_2_8_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2008.11.019"},{"issue":"344","key":"e_1_2_8_26_2","first-page":"354","article-title":"Blood transfusion and cancer surgery outcomes: a continued reason for concern","volume":"152","author":"Al\u2010Refaie WB","year":"2012","journal-title":"Surgery"},{"key":"e_1_2_8_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000001574"},{"key":"e_1_2_8_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010014\u20100541\u2010x"},{"key":"e_1_2_8_29_2","doi-asserted-by":"publisher","DOI":"10.3109\/08820139509062778"},{"key":"e_1_2_8_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/2052\u20100492\u20102\u201015"},{"key":"e_1_2_8_31_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13613\u2010016\u20100137\u20105"},{"key":"e_1_2_8_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181a38937"},{"key":"e_1_2_8_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(09)60658\u20109"},{"key":"e_1_2_8_34_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318272de70"},{"key":"e_1_2_8_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2010.03.017"},{"key":"e_1_2_8_36_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463\u20101318.2010.02252.x"},{"key":"e_1_2_8_37_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010007\u20109748\u20102"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-018-4687-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-018-4687-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-018-4687-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-018-4687-6","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T23:25:00Z","timestamp":1704929100000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-018-4687-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5,30]]},"references-count":36,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1007\/s00268-018-4687-6"],"URL":"https:\/\/doi.org\/10.1007\/s00268-018-4687-6","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5,30]]},"assertion":[{"value":"30 May 2018","order":1,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no Conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}