| Impact of surgical specialization on emergency colorectal surgery outcomes. | |
| | |
MedLine Citation:
|
PMID: 20083758 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To evaluate the impact of surgeon specialization on emergency colorectal resection in terms of mortality, morbidity, and type of operation performed. DESIGN: Observational study from January 1, 1993, through December 31, 2006. SETTING: Bellvitge University Hospital, Barcelona, Spain. PATIENTS: A total of 1046 patients underwent emergency colorectal resection. Patients were classified into 2 groups: those operated on by a colorectal surgeon (CS) and those operated on by a general surgeon (GS). MAIN OUTCOME MEASURES: Preoperative variables studied were sex, age, American Society of Anesthesiologists grade, associated medical disease, presentation, reason for surgery, and type of operation. Univariate relations between predictors and outcomes were estimated, and multivariate logistic regression analysis was used to assess the prognostic effect of the combination of the variables. RESULTS: Patients in the CS group underwent a significantly higher percentage of resection and primary anastomosis. The postoperative morbidity rate was 52.2% in the CS group and 60.5% in the GS group (P = .01). The anastomotic dehiscence rate was lower in the CS group (6.2%) than in the GS group (12.1%) (P = .01). Postoperative mortality decreased among patients in the CS group (17.9%) with respect to the patients in the GS group (28.3%) (P < .001). Being operated on by a CS was predictive in both the univariate and multivariate analyses for postoperative complications and mortality, and it was the only variable with predictive value for anastomotic dehiscence. CONCLUSIONS: Specialization in colorectal surgery has a significant influence on morbidity, mortality, and anastomotic dehiscence after emergency operations. |
| | |
Authors:
|
Sebastiano Biondo; Esther Kreisler; Monica Millan; Domenico Fraccalvieri; Thomas Golda; Ricardo Frago; Bernat Miguel |
Related Documents
:
|
22244718 - The impact of snow on orthopaedic trauma referrals. 21235668 - Troubleshooting difficult transseptal catheterization. 20435798 - Prevalence and clinical outcome of hyperglycemia in the perioperative period in noncard... 20732518 - Validation of a nomogram predicting complications after esophagectomy for cancer. 15229448 - Interventional eus cholangiography: a report of five cases. 19009298 - The prognostic importance of trauma scoring systems in pediatric patients. |
Publication Detail:
|
Type: Comparative Study; Journal Article |
Journal Detail:
|
Title: Archives of surgery (Chicago, Ill. : 1960) Volume: 145 ISSN: 1538-3644 ISO Abbreviation: Arch Surg Publication Date: 2010 Jan |
Date Detail:
|
Created Date: 2010-01-19 Completed Date: 2010-01-28 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9716528 Medline TA: Arch Surg Country: United States |
Other Details:
|
Languages: eng Pagination: 79-86 Citation Subset: AIM; IM |
Affiliation:
|
Department of Surgery, Bellvitge University Hospital, University of Barcelona, Spain. sebastianobiondo@yahoo.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Anastomosis, Surgical / adverse effects Colectomy / adverse effects* Colon Colonic Diseases / surgery* Colorectal Surgery / statistics & numerical data* Emergencies Female General Surgery / statistics & numerical data* Humans Male Postoperative Complications / epidemiology Rectal Diseases / surgery* Rectum Specialties, Surgical / statistics & numerical data Surgical Wound Dehiscence / epidemiology, etiology Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Improved bariatric surgery outcomes for medicare beneficiaries after implementation of the medicare ...
Next Document: Conversion of emergent cricothyrotomy to tracheotomy in trauma patients.