A one year audit of the Colorectal Unit at Wits Donald Gordon Medical Centre: 2016–2017

Abstract

Background: Colorectal surgery has developed into an established surgical subspecialty in South Africa, however there is a paucity of data regarding the epidemiology and surgical outcomes of patients with colorectal disease in this country. The objective is to present the findings of a one-year audit of the Wits Donald Gordon Medical Centre (WDGMC) Colorectal Unit with specific reference to indications, surgical procedures and patient outcomes. Methods: Patient files from December 2016 to November 2017 were included in a retrospective analysis. The Mann-Whitney U test was used to analyse continuous variables and the Chi-squared test was used to compare categorical variables. Results: During the audit period, 1264 patients were admitted to the Colorectal Unit and a further 564 outpatient endoscopic procedures were performed. There were 306 emergency admissions. 139 elective colorectal resections took place, with a 16% major complication rate, a 12% anastomotic leak rate and no deaths. Rectal resections constituted 66% of the operations and 34% were colonic resections. The median length of stay for all patients undergoing resection was 9 days and there was no statistically significant difference in length of stay between open and laparoscopic cases. Conclusion: The WDGMC Colorectal Unit manages a high volume of patients presenting with the full spectrum of colorectal disease.

Men and Those With a History of Smoking Are Associated With the Development of Postoperative Ileus Following Elective Colorectal Cancer Resection at a Private Academic Hospital in Johannesburg, South Africa: A Retrospective Cohort Study

“…In the present study, the POI incidence rate seen in the study population was 36% (56 POI out of 155 cases) which was higher than anticipated (refer to Table 1). The incidence rate previously reported at the same institution was 13,7% (19 POI out of 139 elective colorectal resections between December 2016 to November 2017) (20). The POI incidence rate reported in a literature review of 11 studies ranged between 2 and 54%, with the median incidence rate reported as 10,3% after colorectal surgery (5).…”

“…The high incidence of POI at the study hospital was identified in the previous study as one of the reasons for prolonged LOS at the institution and some postoperative components of ERAS including limitation of fluid and opioid-sparing strategies were implemented at the study hospital ( 20 ). Due to challenges like high cost and a shortage in resources in SA ( 44 ), full implementation of all ERAS components has not been possible yet ( 20 , 44 ).…”

“…This study aimed to determine centre-specific preoperative risk factors associated with the development of POI as a complication of post-elective therapeutic resection for CRC. To date, there is a scarcity of published data in SA on presentation and outcomes of patients with colorectal disease, especially CRC ( 20 ). The recent publication “A 1 year audit of the Colorectal Unit at Wits Donald Gordon Medical Centre: 2016–2017” by Lutrin et al was one of the first publications of its kind in SA ( 20 ).…”

“…To date, there is a scarcity of published data in SA on presentation and outcomes of patients with colorectal disease, especially CRC ( 20 ). The recent publication “A 1 year audit of the Colorectal Unit at Wits Donald Gordon Medical Centre: 2016–2017” by Lutrin et al was one of the first publications of its kind in SA ( 20 ). In this publication, the activity of the Wits Donald Gordon Medical Centre (WDGMC) Colorectal Unit over a 12-month period was assessed.…”

Patient perceptions of surgical training in the private sector in South Africa - a single centre survey

“…However, this exclusion does not represent a source of significant bias in sampling, as the rate of major complications in the WDGMC CRU for the study period was approximately 7.8%, which is consistent with international complication rates. 22 MARCH 2022…”