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Unplanned Reoperation Following Colorectal Surgery: Indications and Operations

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Aim

Prior studies have demonstrated a reoperation rate ranging from 5.8 to 7.6% following colorectal surgery. However, the indications for reoperation have not been extensively evaluated. We aimed to describe the indications for reoperation and associated procedures following colorectal resection.

Methods

This is a retrospective cohort study of all patients undergoing colorectal resection at a single institution from 2003 to 2013. For patients who returned to the operating room, the primary indication was categorized into mutually exclusive categories and all procedures performed within 30 days of the initial operation were indexed. Univariate and multivariate analyses were performed.

Results

We identified 2793 patients who underwent colorectal operations, of which 407 (14.6%) were emergent. A total of 178 (6.7%) patients returned to the operating room. On multivariate analysis, emergent operation, malnutrition, corticosteroid use, and operative duration were independently associated with reoperation; independent functional status was protective. The most common indications for reoperation were anastomotic leak and bowel obstruction. The most common procedures performed were ostomy creation, bowel resection, and adhesiolysis.

Conclusions

Reoperation after colorectal surgery is a relatively common occurrence for which we have identified the risk factors, most common indications, and specific procedures performed. This knowledge will help identify areas for improvement.

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Author information

Authors and Affiliations

Authors

Contributions

ADM: design of the work, acquisition of data, interpretation of data, drafting manuscript, critical revision, final approval, accountability. MGM: design of the work, acquisition of data, interpretation of data, drafting manuscript, final approval, accountability. CAG: analysis of data, interpretation of data, drafting manuscript, final approval, accountability. EDK: interpretation of the data, drafting manuscript, final approval, accountability. FET: conception and design of the work, critical revision of manuscript, final approval, accountability. TLH: conception of the work, interpretation of data, critical revision of manuscript, final approval, accountability. CMF: conception and design of the work, interpretation of data, critical revision of manuscript, final approval, accountability.

Corresponding author

Correspondence to Charles M. Friel.

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Grant Support

T32AI0074 (ADM), NIH T32CA163177 (MGM)

Additional information

Meeting Presentation

Society of American Gastrointestinal and Endoscopic Surgeons 2016 Annual Meeting, Boston, MA, March 2016

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Michaels, A.D., Mullen, M.G., Guidry, C.A. et al. Unplanned Reoperation Following Colorectal Surgery: Indications and Operations. J Gastrointest Surg 21, 1480–1485 (2017). https://doi.org/10.1007/s11605-017-3447-5

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  • DOI: https://doi.org/10.1007/s11605-017-3447-5

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