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Current outcomes of emergency large bowel surgery
#MMPMID25723694
Ng HJ
; Yule M
; Twoon M
; Binnie NR
; Aly EH
Ann R Coll Surg Engl
2015[Mar]; 97
(2
): 151-6
PMID25723694
show ga
INTRODUCTION: Emergency large bowel surgery (ELBS) is known to carry an increased
risk of morbidity and mortality. Previous studies have reported morbidity and
mortality rates up to 14.3%. However, there has not been a recent study to
document the outcomes of ELBS following several major changes in surgical
training and provision of emergency surgery. The aim of this study was therefore
to explore the current outcomes of ELBS. METHODS: A retrospective review was
performed of a prospectively maintained database of the clinical records of all
patients who had ELBS between 2006 and 2013. Data pertaining to patient
demographics, ASA (American Society of Anesthesiologists) grade, diagnosis,
surgical procedure performed, grade of operating surgeon and assistant, length of
hospital stay, postoperative complications and in-hospital mortality were
analysed. RESULTS: A total of 202 patients underwent ELBS during the study
period. The mean patient age was 62 years and the most common cause was colonic
carcinoma (n=67, 33%). There were 32 patients (15.8%) who presented with
obstruction and 64 (31.7%) had bowel perforation. The overall in-hospital
mortality rate was 14.8% (n=30). A consultant surgeon was involved in 187 cases
(92.6%) as either first operator, assistant or available in theatre. CONCLUSIONS:
ELBS continues to carry a high risk despite several major changes in the
provision of emergency surgery. Further developments are needed to improve
postoperative outcomes in these patients.
|*Emergencies
[MESH]
|*Hospital Mortality
[MESH]
|Adult
[MESH]
|Aged
[MESH]
|Aged, 80 and over
[MESH]
|Colorectal Neoplasms/epidemiology
[MESH]
|Digestive System Surgical Procedures/statistics & numerical data
[MESH]
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