ThTP5.8 Single centre, single surgeons’ experience of laparoscopic emergency surgery from a tertiary care NHS hospital: delay in surgery is associated with higher mortality and morbidity

Abstract

Abstract Aims The objective of this article is to present a single centre experience of laparoscopic emergency surgery reporting outcomes influenced by delay in surgery. Methods A retrospective review of case notes to evaluate postoperative outcomes in patients undergoing laparoscopic emergency gastrointestinal surgery. Results There were 172 major laparoscopic emergency procedures over a span of 5 years. Forty-one colorectal resections were performed within 48 hours of admission (group A) compared to 50 resections (group B) after 48 hours. Mean hospital stay was shorter in group A (10.57 versus 19.97) days. No mortality reported in the group A whereas 4 patients died (8%) in group B. Lower morbidity percentage was also observed in group A (14.6 % versus 22 %). Twenty small bowel resections were performed within 48 hours of admission (group C) compared to 6 resections (group D) after 48 hours. Mean hospital stay was shorter in group C (8.6 versus 29.5) days. 3 patients died (15%) in group C whereas no mortality reported in the group D. Lower morbidity was also observed in group C (14.6 % versus 22 %). Laparoscopic adhesiolysis was performed in 28 patients and significant reduced hospitalization (3.6 versus 12.5 days) and reduced morbidity (0 versus 0) was noted in patients undergoing surgery within 48 hours of the admission. Laparoscopic hernia repair was performed in 20 patients and significant reduced hospitalization (4.5 versus 8.2 days) and reduced morbidity (13.7% versus 20%) was noted among patients who underwent surgery within 48 hours of admission. Conclusion Early laparoscopic surgery in acutely ill surgical patients is associated with better surgical outcomes