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Epidemiological trends in surgery for rectal prolapse in England 2001-2012: An adult hospital population-based study

Epidemiological trends in surgery for rectal prolapse in England 2001-2012: An adult hospital population-based study Thumbnail


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.

Acceptance Date Apr 29, 2020
Publication Date Apr 29, 2020
Publicly Available Date Mar 28, 2024
Journal Colorectal Disease
Print ISSN 1462-8910
Publisher Wiley
DOI https://doi.org/10.1111/codi.15094
Publisher URL https://onlinelibrary.wiley.com/doi/abs/10.1111/codi.15094

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