Patterns and Outcomes of Elective versus Non-Elective Rectal Prolapse Repair: an ACS-NSQIP Analysis

Area of Science:

• Colorectal Surgery
• Surgical Outcomes Research

Background:

• Limited data exists on the presentation and outcomes of rectal prolapse surgery in non-elective settings.
• Understanding short-term outcomes is crucial for managing emergency rectal prolapse cases.

Purpose of the Study:

• To evaluate short-term postoperative outcomes after non-elective rectal prolapse surgery.
• To compare outcomes of non-elective rectal prolapse repair with elective procedures.

Main Methods:

• Retrospective cohort study utilizing a multicenter North American database.
• Included adult patients (18+) undergoing surgery for rectal prolapse.
• Compared outcomes between non-elective and elective surgical groups, focusing on 30-day morbidity, mortality, re-operation, and readmission.

Main Results:

• Non-elective rectal prolapse surgery (9.2% of cases) was associated with significantly higher 30-day postoperative morbidity, mortality, re-operation, and unplanned readmission compared to elective surgery.
• Patients undergoing non-elective surgery were older, more functionally dependent, and more likely to have a perineal approach.
• Emergent non-elective surgery demonstrated incrementally higher risks of morbidity and mortality than non-emergent non-elective surgery.

Conclusions:

• Non-elective rectal prolapse surgery is independently associated with worse short-term postoperative outcomes.
• The increased risks observed in non-elective cases persist across different surgical approaches.
• These findings highlight the need for careful consideration in managing non-elective rectal prolapse.