El‐Dhuwaib, Y, Pandyan, A ORCID: https://orcid.org/0000-0002-2180-197X and Knowles, CH (2020) Epidemiological trends in surgery for rectal prolapse in England 2001‐2012: An adult hospital population‐based study. Colorectal Disease.

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Abstract

Background
This study analysed trends in admission and surgery for rectal prolapse in adults in England between 2001 and 2012 as well as prolapse reoperation rates.

Methods
Analysis of data derived from a comparative longitudinal population‐based cohort study using Hospital Episode Statistics (HES).

Results
During the study period, a total of 25,238 adults underwent a total of 29,379 operations for rectal prolapse (mean 2,662 per annum) [median age 73 years (IQE 58‐83) years; female to male ratio: 7:1]. Median length‐of‐stay was 3 days (IQR 1‐7) with an overall in‐hospital mortality rate of 0.9%. Total number of admissions (2001: 4,950 vs. 2012: 8,927) and of patients undergoing prolapse surgery (2001: 2,230 vs. 2012: 2,808) significantly increased over the study period (P < 0.001 for trends). The overall increase in prolapse surgery (up by 1/3rd overall and 44% for elective) was dwarfed by an increase in popularity of laparoscopic surgery (increasing 15‐fold). Overall prolapse reoperation rate was 12.7%. The lowest recurrence rate was observed for elective open resection (9.1%) but this had the highest mortality (1.9%). Laparoscopic and perineal fixations were also associated with low reoperation rates (<11%) but lower mortality rates, in the order of 0.3% for elective surgery. These data refute a trend toward subspecialisation (by surgeon or hospital) during the study period.

Conclusions
Admissions for rectal prolapse increased in England between 2001‐2012 together with increases in surgery. Surgical decision making has changed over the period and may be reflected in outcome.

Item Type: Article
Additional Information: The final version of this article and all relevant information regarding this can be found at; https://onlinelibrary.wiley.com/doi/abs/10.1111/codi.15094
Subjects: Q Science > Q Science (General)
R Medicine > R Medicine (General)
R Medicine > R Medicine (General) > R735 Medical education. Medical schools. Research
R Medicine > RA Public aspects of medicine
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RD Surgery
Divisions: Faculty of Medicine and Health Sciences > School of Allied Health Professions
Depositing User: Symplectic
Date Deposited: 22 May 2020 13:55
Last Modified: 22 May 2020 13:55
URI: http://eprints.keele.ac.uk/id/eprint/8003

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