Re-operation following urgent and emergent colectomies: An investigation of indications and utility as a quality indicator

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2024-11-09 DOI:10.1016/j.amjsurg.2024.116081

Raisa Gao, Kayla Flewelling, Nicholas Stevens, Clayton Wyland, Theresa McGoff, Austin Brubaker, Laurence E. McCahill

{"title":"Re-operation following urgent and emergent colectomies: An investigation of indications and utility as a quality indicator","authors":"Raisa Gao, Kayla Flewelling, Nicholas Stevens, Clayton Wyland, Theresa McGoff, Austin Brubaker, Laurence E. McCahill","doi":"10.1016/j.amjsurg.2024.116081","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>For urgent and emergent colectomies, return to the operating room is interpreted as a negative quality indicator. We sought to describe indications, procedures performed, and outcomes of patients undergoing reoperation after colectomy.</div></div><div><h3>Methods</h3><div>Retrospective study of patients undergoing urgent and emergent colectomy with re-operation at a single institution from 2013 to 2023. Details of the patients and surgeries indexed.</div></div><div><h3>Results</h3><div>117 patients met the study criteria. Sepsis prior to surgery was noted in 29 % of patients, intraoperative vasopressors were used in 80 % and 52 % were left in gastrointestinal discontinuity. Among re-operations, 60 % of patients underwent a “planned second look”, 17 % had a supportive procedure, and 23 % had an unplanned re-operation, the latter group most reflective of surgical complications.</div></div><div><h3>Conclusion</h3><div>Patients undergoing urgent and emergent colectomies are very ill at presentation. Planned second look and supportive procedures account for most re-operations, suggesting the current utilization of re-operation as a quality indicator is flawed.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"241 ","pages":"Article 116081"},"PeriodicalIF":2.7000,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0002961024006330","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

For urgent and emergent colectomies, return to the operating room is interpreted as a negative quality indicator. We sought to describe indications, procedures performed, and outcomes of patients undergoing reoperation after colectomy.

Methods

Retrospective study of patients undergoing urgent and emergent colectomy with re-operation at a single institution from 2013 to 2023. Details of the patients and surgeries indexed.

Results

117 patients met the study criteria. Sepsis prior to surgery was noted in 29 % of patients, intraoperative vasopressors were used in 80 % and 52 % were left in gastrointestinal discontinuity. Among re-operations, 60 % of patients underwent a “planned second look”, 17 % had a supportive procedure, and 23 % had an unplanned re-operation, the latter group most reflective of surgical complications.

Conclusion

Patients undergoing urgent and emergent colectomies are very ill at presentation. Planned second look and supportive procedures account for most re-operations, suggesting the current utilization of re-operation as a quality indicator is flawed.

查看原文本刊更多论文

紧急结肠切除术后的再次手术：作为质量指标的适应症和效用调查。

背景：对于紧急和急诊结肠切除术而言，返回手术室被视为一项负面的质量指标。我们试图描述结肠切除术后再次手术患者的适应症、手术过程和结果：方法：对 2013 年至 2023 年期间在一家医疗机构接受紧急结肠切除术并再次手术的患者进行回顾性研究。结果：117 名患者符合研究标准：117例患者符合研究标准。29%的患者在手术前出现败血症，80%的患者在术中使用了血管加压药，52%的患者在术后出现胃肠道中断。在再次手术中，60%的患者接受了 "有计划的二次观察"，17%的患者接受了支持性手术，23%的患者接受了计划外再次手术，后者最能反映手术并发症的情况：结论：接受紧急结肠切除术的患者在就诊时病情都很严重。结论：接受紧急和急诊结肠切除术的患者在就诊时病情都很严重，计划中的二次探视和支持性手术占再次手术的大多数，这表明目前将再次手术作为质量指标的做法存在缺陷。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.