| Title: |
SP1.11 Hospitals offering emergency laparoscopic surgery have improved outcomes |
| Authors: |
Eid, Joana; Finch, Louise; Mercer, Stuart |
| Source: |
British Journal of Surgery ; volume 110, issue Supplement_6 ; ISSN 0007-1323 1365-2168 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2023 |
| Description: |
Aims Only 20% of patients requiring emergency surgery in the UK are offered laparoscopic surgery; there is wide variability in uptake of laparoscopic emergency surgery between hospitals, ranging from 0% to over 80% of cases. This study investigated whether hospitals with an advanced laparoscopic culture had improved outcomes. Methods The national NELA database was interrogated to identify patients requiring surgery for adhesional small bowel obstruction; this was selected because it is common (around 25% of cases in NELA) and often amenable to laparoscopic surgery. Hospitals were grouped into quintiles, according to the number of cases attempted by the laparoscopic approach; each group was assessed for length of stay and mortality. Results In 176 acute hospitals, 20597 operations were performed for adhesional SBO. Overall mortality was 6.2%. In the quintile with the lowest rate of laparoscopy, 4% of cases were started laparoscopically, compared with 44% in the highest quintile. In the lowest quintile, 4.8% of patients were discharged within 3 days, compared to 13.8% in the highest quintile; discharge at 7 days was 26% versus 37%. Overall, 30-day mortality in the group with the lowest rate of laparoscopy was 6.9%, compared with 5.4% in hospitals with the highest rate of laparoscopy (p |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/bjs/znad241.021 |
| Availability: |
https://doi.org/10.1093/bjs/znad241.021; https://academic.oup.com/bjs/article-pdf/110/Supplement_6/znad241.021/51302177/znad241.021.pdf |
| Rights: |
https://academic.oup.com/pages/standard-publication-reuse-rights |
| Accession Number: |
edsbas.532276E |
| Database: |
BASE |