Re-operation Following Urgent and Emergent Colectomies: An Investigation of Indications and Utility as a Quality Indicator

Abstract

BackgroundFor urgent and emergent colectomies, return to the operating room is interpreted as a negative quality indicator. We sought to describe indications, procedures performed, and outcomes of patients undergoing reoperation after colectomy. MethodsRetrospective study of patients undergoing urgent and emergent colectomy with re-operation at a single institution from 2013 to 2023. Details of the patients and surgeries indexed. Results117 patients met the study criteria. Sepsis prior to surgery was noted in 29% of patients, intraoperative vasopressors were used in 80% and 52% were left in gastrointestinal discontinuity. Among re-operations, 60% of patients underwent a “planned second look”, 17% had a supportive procedure, and 23% had an unplanned re-operation, the latter group most reflective of surgical complications. ConclusionPatients undergoing urgent and emergent colectomies are very ill at presentation. Planned second look and supportive procedures account for most re-operations, suggesting the current utilization of re-operation as a quality indicator is flawed.