SA Naqvi*
Ennis General Hospital and University Hospital Limerick, Ireland
*Corresponding Author: SA Naqvi, Ennis General Hospital and University Hospital Limerick, Ireland.
Received: February 22, 2021; Published: March 16, 2021
The need of Clinical audit has been increased in the last two decades, as it is required for the accreditation process in every healthcare system. Data collection and analysis are excessively time-consuming in everyday practice. The primary aim of our study was to evaluate the colorectal work at small hospital with out ICU facilities, monitoring of our clinical practice and outcome in difficult circumstances and to evaluate the outcome of colorectal surgeries in a small hospital. The second purpose was to observed mortality rates in this small unit to compare with international standards.
Methods Need toData were evaluated from 49 consecutive colo-rectal operations undergoing elective and emergency surgery over a 4-year period (September 2005–May 2009).
The observed mortality rate was 2% and morbidity 14% which was significantly in line with the values published in literature.
Our results show that bowel surgery and primary anastomosis is associated with substantial morbidity and mortality. Those patients who have underlying vascular aetiology had a particularly poor outcome. we had 2% of mortality who underwent bowel surgery in small hospital, even when the operation was delayed till the morning list rather doing in the middle of the night. We had conservative management for some patients with adhesion obstruction and it seems justified. We operated as emergency when there were clear signs of strangulation. The majority cases who got complications were general rather than specific to the bowel surgery. There was only one patient who had an anastomotic leak. The low incidence of complications suggests that bowel surgery remains a good training operation in a County/District hospital.
The study confirms the usefulness of a dedicated database in a surgical audit activity. The overall bowel surgery operations performed in a small hospital with a low 30-day mortality and low in complications in our experience. Total 47 cases (7 complications 14%) [1-10].
Mortality | |
One Mortality |
2% |
Morbidity |
14% |
One bleeding post right hemi |
2% |
One air leak |
2% |
One Prolapse of stoma |
2% |
One anastomotic leak |
2% |
3 Wound infection |
6% |
Procedures |
Complications |
Reversal of Hartman’s Procedure |
None |
Laparotomy for Adhesions |
None |
Bleeding DU repair |
None |
Laparotomy Small Bowel anastomosis |
None |
Laparotomy division of bowel adhesions |
None |
Division of bowel adhesions |
Wound infection |
Laparotomy bowel resection |
None |
Anterior resection |
None |
Right hemicolectomy |
None |
Colostomy |
None |
Resection of bowel and stoma |
None |
Laparotomy and aortic L/N biopsy |
None |
Perforated DU laparotomy |
None |
Right hemicolectomy |
|
Hematoma evacuation post right hemicolectomy |
Bleeding Hematoma formation |
Laparotomy for bowel obstruction |
None |
Right hemicolectomy |
None |
Anterior Resection |
None |
Diagnostic Laparotomy for bowel obstruction |
None |
Laparotomy Small Bowel Resection |
None |
Laparotomy resection of bowel |
None |
Sigmoid colectomy |
None |
Loop colostomy due to air leak |
Anastomotic air leak |
Laparotomy and omental biopsy |
None |
Laparotomy reversal of stoma |
None |
Anterior resection |
Wound infection |
Reversal of stoma |
None |
Laparotomy for perforation DU |
None |
Right hemicolectomy |
None |
Stoma, loop ileostomy for bowel obstruction |
None |
Laparotomy right hemi-colectomy |
None |
Laparotomy for obstruction incision hernia |
None |
loop colostomy for bowel obstruction |
None |
Anterior resection |
None |
Laparotomy bowel resection |
None |
Colostomy for bowel obstruction |
None |
Refashion of for stoma due to prolapsed |
Stoma prolapsed |
Right hemicolectomy |
None |
Laparotomy and bowel resection, perforation |
None |
Laparotomy via RIF wound. Stoma -- --- complication |
Wound infection |
Right hemicolectomy and formation of ileostomy |
Transferred to tertiary hospital and died |
Right hemicolectomy |
None |
Right hemicolectomy |
None |
Laparotomy and Small Bowel resection |
None |
Laparotomy for appendicular abscess |
None |
Laparotomy bowel resection loop ileostomy |
None |
Laparotomy live L/N biopsies |
None |
Table 1:
Citation: SA Naqvi. “Bowel Surgery Audit in a small County/District Hospital". Acta Scientific Gastrointestinal Disorders 4.4 (2021): 28-30.
Copyright: © 2021 SA Naqvi This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.