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Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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Related Experiment Video

Updated: Sep 12, 2025

Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
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Increasing Differences in Surgical Site Infections After Emergency and Elective Colorectal Surgery.

Kevin Sun1, Chen Chia Wang1, Timothy M Geiger2

  • 1Vanderbilt University School of Medicine, Nashville, Tennessee.

The Journal of Surgical Research
|August 8, 2025
PubMed
Summary

Surgical site infection rates are diverging between elective and emergency colorectal surgeries. Emergency cases show no improvement in overall or deep infections, despite increased minimally invasive surgery use.

Keywords:
Colorectal surgeryEmergency surgeryJoinpointNSQIPNational Surgical Quality Improvement ProgramSurgical site infectionTrend

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Area of Science:

  • Colorectal Surgery
  • Infectious Disease Epidemiology
  • Surgical Outcomes Research

Background:

  • Surgical site infections (SSIs) are a major complication after colorectal surgery, increasing patient morbidity and healthcare costs.
  • Trends in SSI rates, particularly the impact of minimally invasive surgery (MIS), require ongoing investigation in both elective and emergency settings.

Purpose of the Study:

  • To analyze temporal trends in SSI incidence following elective versus emergency colorectal surgery.
  • To investigate whether the adoption of MIS has influenced SSI rates differently in elective and emergency procedures.

Main Methods:

  • Retrospective analysis of 229,167 patients undergoing colectomy from 2011-2021 using the National Surgical Quality Improvement Program (NSQIP) database.
  • Joinpoint regression was employed to calculate annual percent changes in SSI rates for elective and emergency cases.
  • Subanalysis examined trends in different SSI types (superficial, deep, organ space) and the utilization of MIS.

Main Results:

  • Elective colorectal surgery demonstrated a significant decline in overall SSI rates, whereas emergency surgery showed no significant change.
  • Superficial and deep SSI rates decreased more significantly in elective cases compared to emergency cases.
  • Organ space SSIs increased at a greater rate in emergency surgery, despite a higher rate of MIS adoption in these cases. Neither elective nor emergency MIS showed significant SSI trend improvements.

Conclusions:

  • A widening disparity in SSI rates exists between elective and emergency colorectal surgery.
  • Emergency colorectal surgery patients experience stagnant or worsening SSI outcomes, including an increase in organ space infections, irrespective of increased MIS utilization.
  • Further strategies are needed to mitigate SSIs in emergency colorectal surgery.