AI Article Synopsis
- The study evaluated how the specialization of surgeons affects outcomes after emergency colorectal surgery, focusing on mortality, morbidity, and the types of operations performed.
- Patients were divided into two groups: those treated by colorectal surgeons (CS) and general surgeons (GS), with the study conducted over a period from 1993 to 2006 at a hospital in Barcelona.
- Results revealed that patients operated on by CSs had better outcomes, including lower morbidity and mortality rates, as well as lower rates of anastomotic dehiscence compared to those treated by GSs, highlighting the importance of surgical specialization in improving patient care.
Article Abstract
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.
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| http://dx.doi.org/10.1001/archsurg.2009.208 | DOI Listing |
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