Colorectal surgery: the risk and burden of adhesion-related complications

Objectives  Adhesions are associated with serious medical complications. This study examines the real‐time burden of adhesion‐related readmissions following colorectal surgery and assesses the impact of previous surgery on adhesion‐related outcomes. Patients and methods  The study used data from the...

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Bibliographic Details
Published in:Colorectal disease 2004-11, Vol.6 (6), p.506-511
Main Authors: Parker, M. C., Wilson, M. S., Menzies, D., Sunderland, G., Thompson, J. N., Clark, D. N., Knight, A. D., Crowe, A. M.
Format: Article
Language:English
Subjects:
Adhesions
Adult
Age Distribution
Aged
Cohort Studies
Colonic Diseases - diagnosis
Colonic Diseases - surgery
colorectal surgery
Colorectal Surgery - adverse effects
Colorectal Surgery - methods
epidemiology
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Patient Readmission - statistics & numerical data
Postoperative Complications - epidemiology
Postoperative Complications - surgery
readmissions
Registries
Reoperation - statistics & numerical data
Risk Assessment
SCAR
Scotland
Sex Distribution
Tissue Adhesions - etiology
Tissue Adhesions - surgery
United Kingdom - epidemiology
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Summary:Objectives  Adhesions are associated with serious medical complications. This study examines the real‐time burden of adhesion‐related readmissions following colorectal surgery and assesses the impact of previous surgery on adhesion‐related outcomes. Patients and methods  The study used data from the Scottish National Health Service Medical Record Linkage Database to identify three cohorts of patients who had undergone open colorectal surgery during the financial years 1996–97, 1997–98 and 1998–99. Each cohort was followed up for at least 2 years and the number and category of adhesion‐related readmissions was recorded. The influence of any previous operations on adhesion‐related readmissions was also determined by performing a subanalysis within the 1996–97 cohort of patients who had no record of abdominal surgery within either the previous 5 or 15 years. The relative risk of adhesion‐related readmissions was also assessed. Results  In the 1996–97 cohort, 9.0% of patients were readmitted within a year after surgery; 2.1% had complications directly related to adhesions and 6.9% had complications that were possibly related. After 4 years, 19.0% of patients were readmitted for reasons directly or possibly related to adhesions. Many patients were readmitted on more than one occasion and the relative risk of adhesion‐related complications was 29.7 per 100 initial procedures over 4 years. In the subgroups that had no record of abdominal surgery within the previous 5 or 15 years, the relative risks of adhesion‐related complications were 24.8% and 23.5%, respectively. There was no change in the rate of adhesion‐related readmissions following colorectal surgery between 1996 and 1999. Conclusion  Colorectal surgery is associated with a considerable rate of adhesion‐related readmissions. Preventative measures should be considered to reduce this risk.
ISSN:1462-8910
1463-1318
DOI:10.1111/j.1463-1318.2004.00709.x