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Related Experiment Videos

Management variability in surgery for colorectal emergencies.

C R Darby1, A R Berry, N Mortensen

  • 1Department of Surgery, John Radcliffe Hospital, Headington, Oxford, UK.

The British Journal of Surgery
|March 1, 1992
PubMed
Summary

Emergency colorectal surgery outcomes vary. Specialist surgeons improved immediate anastomosis rates, reducing mortality. Training in advanced colorectal practices is crucial for all surgeons.

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Area of Science:

  • Colorectal Surgery
  • Surgical Audit
  • Emergency Medicine

Background:

  • Emergency colorectal surgery presents significant mortality and morbidity risks.
  • Management strategies and outcomes can differ based on surgical team expertise.
  • Previous studies often overlook morbidity in survivors of emergency colorectal procedures.

Purpose of the Study:

  • To audit outcomes of emergency colorectal surgery.
  • To compare management and results between specialist and non-specialist surgical teams.
  • To identify areas for improvement in surgical training and practice.

Main Methods:

  • Prospective audit of 92 patients undergoing emergency colorectal surgery over one year.
  • Analysis of mortality rates, resection rates, and specific procedure outcomes (e.g., anastomosis, Hartmann's procedure).

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  • Comparison of management approaches between surgical firms with and without colorectal specialists.

    • Main Results:

    • Overall mortality was 14%; primary resection rate was 79%.
    • Left-sided resection without anastomosis had a 24% mortality rate, higher than right-sided resection with anastomosis (12%). Hartmann's procedure had a 35% mortality rate.
    • Specialist colorectal teams utilized primary resection and immediate anastomosis more frequently (67% vs. 41%) and Hartmann's procedure less often (7% vs. 25%).

    Conclusions:

    • Significant differences exist in the management of colorectal emergencies based on consultant specialization.
    • Immediate left-sided anastomosis can be performed safely.
    • Integrating recent advances in colorectal practice into all surgical training is recommended to standardize care and improve patient outcomes.