Colectomies performed at a rural Australian hospital: a 7-year analysis

Little published data exists documenting the reasons for and outcomes of colectomies in rural Australia. It remains unclear whether patient characteristics, diagnoses, complications and outcomes differ to metropolitan locations.

A retrospective review of prospectively collected data for patients coded with International Classification of Diseases procedure code block 934 and 935 (colectomies) performed at Wimmera Health Care Group: Horsham Campus between July 2004 and July 2011. Records were additionally sought from transfer hospitals.

Two hundred thirty-eight colectomies were performed over the 7-year period: 164 for a colorectal cancer diagnosis, 74 for a non-colorectal cancer diagnosis. For the colorectal cancer colectomies, 80.5% were elective and 19.5% emergency. There were five (3.0%) intraoperative complications. Postoperatively, there were 16 (9.8%) surgical complications. There was a 3.7% return to theatre rate and a 3.0% unplanned readmission rate. There were no anastomotic leaks. The perioperative mortality rate was 5.5%. For the non-colorectal cancer colectomies, 85.1% were emergency and 14.9% elective. There were five (6.8%) intraoperative complications. Postoperatively, there were 14 (18.9%) surgical complications. There was a 12.2% return to theatre rate, a 5.4% unplanned readmission rate and three anastomotic leaks. The perioperative mortality rate was 10.8%.

The outcomes and complications for colectomies appear similar to the accepted standard of surgery in other rural and metropolitan centres. Areas have been identified for improved surgical performance at Wimmera Health Care Group: Horsham Campus.