Current outcomes of emergency large bowel surgery

H J Ng, M Yule, M Twoon, N R Binnie, E H Aly

    Research output: Contribution to journalArticle

    8 Citations (Scopus)

    Abstract

    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.

    Original languageEnglish
    Pages (from-to)151-156
    Number of pages6
    JournalAnnals of the Royal College of Surgeons of England
    Volume97
    Issue number2
    DOIs
    Publication statusPublished - Mar 2015

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    Emergencies
    Hospital Mortality
    Mortality
    Length of Stay
    Morbidity
    Consultants
    Demography
    Databases
    Carcinoma

    Keywords

    • Adult
    • Aged
    • Aged, 80 and over
    • Colorectal Neoplasms
    • Digestive System Surgical Procedures
    • Emergencies
    • Female
    • Hospital Mortality
    • Humans
    • Intensive Care Units
    • Intestinal Obstruction
    • Intestinal Perforation
    • Intestine, Large
    • Ischemia
    • Male
    • Middle Aged
    • Multiple Organ Failure
    • Patient Admission
    • Peritonitis
    • Postoperative Complications
    • Retrospective Studies
    • United Kingdom
    • Young Adult
    • Journal Article

    Cite this

    Current outcomes of emergency large bowel surgery. / Ng, H J; Yule, M; Twoon, M; Binnie, N R; Aly, E H.

    In: Annals of the Royal College of Surgeons of England, Vol. 97, No. 2, 03.2015, p. 151-156.

    Research output: Contribution to journalArticle

    Ng, H J ; Yule, M ; Twoon, M ; Binnie, N R ; Aly, E H. / Current outcomes of emergency large bowel surgery. In: Annals of the Royal College of Surgeons of England. 2015 ; Vol. 97, No. 2. pp. 151-156.
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    abstract = "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.",
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    T1 - Current outcomes of emergency large bowel surgery

    AU - Ng, H J

    AU - Yule, M

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    N2 - 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.

    AB - 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.

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