AIDS-related abdominal disease does not increase surgery risk in AIDS patients

Although AIDS-related pathologies are often found at laparotomy in HIV-infected patients, these diseases do not increase the risk of surgical complications or postoperative death, according to a report published in the February issue of the British Journal of Surgery.

Dr. A. J. Chambers and Dr. R. S. A. Lord, from St. Vincent’s Hospital, in New South Wales, Australia, assessed the incidence of AIDS-related pathologies at surgery in 30 patients with AIDS who underwent laparotomy.

Fourteen patients had AIDS-related diseases, 13 had non-AIDS-related diseases, and in 3 patients no abnormality was detected, the authors report. The 30-day mortality rate was 17%, and complications occurred in 21 patients.

Patients with AIDS-related pathologies had a lower mean serum albumin concentration, CD4+ cell count, and body weight, and were hospitalised longer than patients with non-AIDS-related diseases. However, both groups experienced a similar number of complications and deaths. “Surgeons who have to manage abdominal conditions in patients with AIDS, both acute and elective, should be aware of the relative frequency of AIDS-related malignancy and infection found at surgery in these patients,” the researchers note.

Dr. Chambers and Dr. Lord believe that “given the relatively high rates of morbidity and mortality associated with laparotomy in these patients, surgeons should consider conservative and medical management wherever possible.”