Outcomes in patients undergoing urgent colorectal surgery

Abstract

In patients undergoing an urgent resection within a colorectal unit, performing a primary anastomosis is feasible and safe in the majority, relaparotomies are required in a minority and urgent surgery is an important predictor of worse prognosis in those with colorectal cancer.

Operative intervention rates for acute diverticulitis: a multicentre state‐wide study

“…Resection with primary anastomosis, with or without proximal diversion, has been encouraged in acute complicated diverticulitis . A recent Australian series reported a primary anastomosis rate of 62.6% in patients requiring urgent colorectal surgery, some of which were for acute diverticulitis . The proposed benefits include no stoma or easier subsequent reversal of stoma.…”

“…[11][12][13][14] A recent Australian series reported a primary anastomosis rate of 62.6% in patients requiring urgent colorectal surgery, some of which were for acute diverticulitis. 15 The proposed benefits include no stoma or easier subsequent reversal of stoma. Our data clearly demonstrate that this practice has not been widely adopted in Victorian metropolitan specialist centres.…”

Recurrence in patients with stage I colorectal cancer

“…Keum et al, in a study of 434 patients with stage I colon or rectal cancer, found on multivariate analysis a trend towards increased disease recurrence in patients with rectal tumours or T2 disease. 25 Post-treatment surveillance protocols have been used aiming to allow earlier detection of recurrence and ultimately improve outcomes. Iida et al had previously demonstrated in an analysis of 284 patients with T1 colon or rectal cancer that lymphatic invasion was independently associated with disease recurrence.…”

Components of Hospital Perioperative Infrastructure Can Overcome the Weekend Effect in Urgent General Surgery Procedures

“…On the patient level, comorbid disease burden, age, race, and socioeconomic status represent some, but not all, of the potential influencers of in-hospital and postoperative outcomes. 1–3 Moving beyond the individual patient, hospital-level characteristics, such as volume, trauma-level designation, and resident participation can also impact perioperative outcomes after urgent and emergent general surgery. 4–7 The diversity of influences on surgical outcomes is further illustrated by temporal patterns seen in the quality of surgical care.…”