Reoperation in colorectal cancer surgery

Abstract

Background Reoperations in colorectal surgery are usually a consequence of major surgical complications. Recently, the rate of reoperation has been proposed as a marker of surgical performance. Yet, the incidence of re-intervention varies significantly in literature, ranging from 5,2 % to 13 %. Therefore, in this study, we investigated 30-day reoperation rates and made an attempt to identify risk factors of re-intervention following colorectal resection at our institution. Methods This is a retrospective study of patients who had undergone colorectal resection at a single institution from 2013 to 2017. Univariate and multivariate analysis of predicting factors were performed. Results Out of 464 patients included 51 required reoperations (11%). The most common causes of reoperations were anastomotic leakage, postoperative bleeding, and wound dehiscence. In univariate analysis the age of the patient and location of the tumor were related to an increased rate of reoperation. In multivariate analysis patients older than 75 (OR = 2.1; 95%CI = 1.1-3.9) and tumors sited in the rectum (OR = 2.66; 95%CI = 1.4-5) were associated with an increased risk of re-intervention. Patients who required postoperative re-intervention stayed in hospital longer (14 vs. 6 days, p <0.0001) and had higher mortality (9.8% vs. 1.2%, p=0.002). Conclusions Our study shows that reoperation rates that follow colorectal surgery are frequently undervalued. In our series, 11% of patients required an unplanned return to the operative room. The patient’s age and the rectal tumors were the two independent factors that affect the rate of reoperation.