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ABDOMINAL SURGERY IN HIV/AIDS PATIENTS: INDICATIONS, OPERATIVE MANAGEMENT, PATHOLOGY AND OUTCOME
Author(s) -
Yii Ming Kon,
Saunder Alan,
Scott David F.
Publication year - 1995
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1995.tb00646.x
Subject(s) - medicine , asymptomatic , surgery , sepsis , retrospective cohort study
Despite the increasing number of patients with the human immunodeficiency virus (HIV) infection. surgical experience with these patients remains limited. A retrospective review over a 9 year period (January 1985 to December 1993) was undertaken to determine the indications, operative management. pathologic findings and outcome of major abdominal surgery in these patients. A total of 51 procedures were performed in 45 patients; 30 patients had acquired immunodeficiency syndrome (AIDS) and IS patients had asymptomatic HIV infection. Indications included gastrointestinal bleeding. complicated pancreatic pseudocysts. cholelithiasis. bowel obstruction, immune disorders, acute abdomens. elective laparotomy. colostomy formation. menorrhagia and Caesarean section. Pathologic findings directly related to the HIV infection were found in 81% of the AIDS patients and 35% of the asymptomatic HIV infected patients (P<0.05). These included opportunistic infections. non‐Hodgkin's lymphoma. Kaposi's sarcoma, immune disorders. lymphadenopathy and pancreatic pseudocysts. It was noted that AIDS patients had more complications than asymptomatic HIV infected patients with most complications related to chest problems and sepsis (61 vs 7%; P<0.01 ). Emergency operations carried a higher complication rate than elective operations though this was not significant. The hospital mortality was 12%. On follow up, 13 of the 25 AIDS patients had died with the median survival of 7 months, while three of the 14 asymptomatic HIV infected patients had died with the median survival of 40 months. Of the remaining patients, the 12 AIDS patients had a median postoperative follow up of 7 months and the 11 asymptomatic HIV infected patients had a median postoperative follow up of 29.5 months. Despite impaired immune function, surgical treatment of HIV infected patients with abdominal pathology can be practised with acceptable mortality and morbidity and be of major benefit to these patients.