Re-operation following urgent and emergent colectomies: An investigation of indications and utility as a quality indicator

Background: For urgent and emergent colectomies, return to the operating room is interpreted as a negative quality indicator. We sought to describe indications, procedures performed, and outcomes of patients undergoing reoperation after colectomy.

Methods: Retrospective study of patients undergoing urgent and emergent colectomy with re-operation at a single institution from 2013 to 2023. Details of the patients and surgeries indexed.

Results: 117 patients met the study criteria. Sepsis prior to surgery was noted in 29 ​% of patients, intraoperative vasopressors were used in 80 ​% and 52 ​% were left in gastrointestinal discontinuity. Among re-operations, 60 ​% of patients underwent a "planned second look", 17 ​% had a supportive procedure, and 23 ​% had an unplanned re-operation, the latter group most reflective of surgical complications.

Conclusion: Patients undergoing urgent and emergent colectomies are very ill at presentation. Planned second look and supportive procedures account for most re-operations, suggesting the current utilization of re-operation as a quality indicator is flawed.