Surgical Management of Lower Gastrointestinal Hemorrhage: An Analysis of the ACS NSQIP Database

Abstract

Background: Despite advances in diagnostics for lower gastrointestinal bleeding, colorectal resection remains the only option when non-surgical management fails. This study examines a cohort of patients who underwent surgery for this indication to determine the effect of procedure type on postoperative outcomes.

Methods: We identified all patients who underwent colorectal resection for bleeding in the ACS NSQIP Participant Use Data File and the Procedure Targeted PUF for colectomy from 2012 to 2013. We compared patients who underwent partial versus total colectomy using univariate analyses and multivariable logistic regression.

Results: Of 38,486 colorectal resections performed for bleeding, 85.3% underwent a partial colectomy and 14.7% underwent total colectomy. Patients who had total colectomy were more likely to receive more than four units of blood prior to surgery and have operative times longer than 180 min. Patients who had partial colectomy were more likely to have laparoscopic procedures and to have a stoma created during surgery. On univariate analysis, total colectomy was associated with increased risk of postoperative ileus, cardiac and renal complications, and mortality. On multivariate analysis, total colectomy was associated with increased risk of cardiac and renal complications.

Conclusion: The most common procedure performed for lower gastrointestinal hemorrhage was partial colectomy.




J Curr Surg. 2017;7(1-2):4-6
doi: https://doi.org/10.14740/jcs307w