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Unplanned return to the operating room

W H Isbister1

  • 1University Department of Surgery, Wellington, New Zealand. isbister@kfshrc.edu.sa

The Australian and New Zealand Journal of Surgery
|March 11, 1998
PubMed
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Unplanned returns to the operating room (OR) after colorectal surgery are linked to patient factors and surgeon skill. Identifying these factors can improve surgical quality and patient outcomes.

Area of Science:

  • Colorectal Surgery
  • Surgical Quality Improvement
  • Patient Safety

Background:

  • Unplanned return to the operating room (OR) is a potential indicator of surgical quality.
  • Identifying factors necessitating re-operation is crucial for enhancing patient care in colorectal surgery.

Purpose of the Study:

  • To identify factors influencing unplanned returns to the OR after colorectal surgical procedures.
  • To analyze the relationship between patient characteristics, surgical approach, and re-operation rates.

Main Methods:

  • Retrospective analysis of colorectal surgery patients requiring unplanned return to the OR over 15 years.
  • Examination of disease site, presentation, surgical type, re-operation reasons, and outcomes.
  • Data collected from a colorectal service unit database.

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Main Results:

  • 37 patients (1.8%) had unplanned returns to the OR; most common reason was postoperative adhesive obstruction.
  • Colorectal cancer was the primary diagnosis; lesions often in the sigmoid colon or rectum.
  • Complications included wound dehiscence, anastomotic leakage, intra-abdominal sepsis, and urinary tract infections; 18.9% postoperative mortality.

Conclusions:

  • Unplanned OR returns are influenced by patient condition and surgeon expertise.
  • Patient case-mix significantly impacts re-operation rates within surgical units.