Evidence map›Paper›PMID 41888059›Full record

Observational studyWorld journal of surgery2026

Exploratory Laparotomy After Routine Cardiac Surgery: Results From 17,000 Patients.

Megan Turner, James A Brown, Pyongsoo Yoon, Michelle Yoon, Zeyu Liu, Zihan Feng, Ryan Rivosecchi, Holt Murray, Jianhui Zhu, Floyd Thoma and 7 more

Abstract readObservational Study
In one paragraph

Observational study in World journal of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Megan TurnerDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
James A BrownDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Pyongsoo YoonDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Michelle YoonDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Zeyu LiuDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Zihan FengDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Ryan RivosecchiDepartment of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Holt MurrayDepartment of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Jianhui ZhuDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Floyd ThomaDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Derek Serna-GallegosDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
David KaczorowskiDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Johannes BonattiDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Danny ChuDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Irsa HasanDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Takuya OgamiDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.ORCID https://orcid.org/0000-0001-6659-2617
Ibrahim SultanDivision of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study sought to elucidate the incidence and risk factors for exploratory laparotomy ("exlap") after cardiac surgery, its associated perioperative complications, and its impact on long-term survival.

methodsThis was an observational study of consecutive STS index cardiac operations between 2010-2022, excluding circulatory arrest, transplant, and multivalvular cases. The cohort was dichotomized by the incidence of exlap in the postoperative period.

resultsA total of 17,362 patients were included, of which 77 (0.5%) underwent an exlap. Postoperatively, the exlap group required more intra-aortic balloon pumps (IABP), vasopressors, and rescue therapy (i.e., methylene blue or hydroxocobalamin) than the no-exlap group. The exlap group had higher operative mortality, stroke, prolonged ventilation, sepsis, dialysis, mediastinal re-exploration, and pRBC transfusions. On multivariable logistic regression, total number of postoperative pressors, use of rescue therapy, preoperative IABP, white race, chronic dialysis use, and history of cerebrovascular accident were associated with the need for postoperative exlap. On multivariable logistic regression, exlap was an independent risk factor for operative mortality (OR 3.67, 95% CI: 1.95-6.88, p < 0.001). Among patients surviving to discharge, Kaplan-Meier survival estimates were lower in the exlap group compared to the no-exlap group (p < 0.001), with 5-year survival being 58.9% (42.6-74.2) in the exlap group versus 84.4% (83.8-85.0) in the no-exlap group.

conclusionsExploratory laparotomy is rare after open-heart surgery, and it was performed for gastrointestinal complications that occurred in the context of other severe postoperative complications. Several factors were associated with the need for exlap, including increasing age, pre-existing renal and vascular disease, and pre- and post-operative shock.

Indexed as

Cardiac Surgical ProceduresLaparotomyPostoperative ComplicationsAgedFemaleHumansIncidenceMaleMiddle AgedRetrospective StudiesRisk Factorsaortic valve replacementcoronary artery bypass graftingexploratory laparotomymitral valve surgeryoutcomesperioperative care

Identifiers

PMID41888059
PMCPMC13206261

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.