Key result
Nonemergent colorectal surgery in 327 veterans was associated with a 30-day composite morbidity rate of 24.1%, while laparoscopic utilization increased from 22.2% in 2008 to 61.1% in 2018.
Why the study?
To benchmark outcomes and experiences of patients undergoing colorectal surgery at a tertiary Veterans Affairs Medical Center over a 10-year period amid advances in minimally invasive techniques and enhanced recovery programs.
Observational (n=327)
No
A 10-year retrospective review of veterans undergoing nonemergent colorectal surgery demonstrated a 24.1% 30-day morbidity rate and a growing trend toward laparoscopic approaches.
Introduction: The past decade has witnessed numerous advances in colorectal surgery secondary to minimally invasive surgery, evidence-based enhanced recovery programs, and a growing emphasis on patient-centered outcomes. The purpose of this study is to benchmark outcomes and experiences of patients undergoing colorectal surgery at a tertiary Veterans Affairs Medical Center for a 10-year period. Materials and Methods: Veterans who underwent nonemergent colorectal procedures between 2008 and 2018 were identified using targeted Current Procedural Terminology (CPT) codes and the Computerized Patient Record System. Patient outcomes were captured using the Veterans Affairs Surgical Quality Improvement Program and focused on length of stay and aggregate postoperative morbidity profiles. SAS ® Version 9.4 (SAS Institute Inc., Cary, NC) was used for all data analysis with P < .05 used to indicate significance. Results: In total, 327 patients underwent colon/rectal resection at our medical center. Of whom 95% of patients were male and the average age was 66 years. The median length of stay after surgery was 8 days. Within the 30-day postoperative period, the composite morbidity score was 24.1%: most notable being superficial surgical site infections (6.5%), wound dehiscence (4.6%), and pneumonia (3.1%). Over the course of the study period, the laparoscopic approach increased in utilization, with 22.2% of cases performed laparoscopically in 2008 that rose to 61.1% in 2018. Conclusion: Cataloging this decade of practice provides a foundation for future changes in the field of colorectal surgery and in the treatment of veterans. Understanding historical outcomes should help identify areas for ongoing process improvement and guide targeted approaches to quality metrics.
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Napolitano et al. (2020) conducted an observational in Nonemergent colorectal procedures (n=327). Nonemergent colorectal surgery was evaluated on Composite morbidity score within 30 days. Nonemergent colorectal surgery in 327 veterans was associated with a 30-day composite morbidity rate of 24.1%, while laparoscopic utilization increased from 22.2% in 2008 to 61.1% in 2018.
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