El‐Dhuwaib, Y, Pandyan, A and Knowles, CH (2020) Epidemiological trends in surgery for rectal prolapse in England 2001‐2012: An adult hospital population‐based study. Colorectal Disease, 22 (10). pp. 1359-1366. ISSN 1462-8910

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To analyse trends in admission and surgery for rectal prolapse in adults in England between 2001 and 2012 as well as prolapse reoperation rates.

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

During the study period, a total of 25 238 adults, of median age 73 [interquartile range (IQR: 58–83] years, underwent a total of 29 379 operations for rectal prolapse (mean: 2662 per annum). The female to male ratio of this group of patients was 7:1. Median length of hospital stay was 3 (IQR: 1–7) days with an overall in‐hospital mortality rate of 0.9%. Total number of admissions (4950 in 2001/2002 vs 8927 in 2011/2012) and of patients undergoing prolapse surgery (2230 in 2001/2002 vs 2808 in 2011/2012) significantly increased over the study period (P < 0.001 for trends). The overall increase in prolapse surgery (of 33% overall and of 44% for elective procedures) was dwarfed by an increase in popularity of laparoscopic surgery (of 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%) and the lowest mortality rates, of 0.3%, when these procedures were elective. These data refute a trend towards subspecialization (by surgeon or hospital) during the study period.

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

Item Type: Article
Additional Information: © 2020 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Any more information required can be found at; https://onlinelibrary.wiley.com/doi/abs/10.1111/codi.15094
Uncontrolled Keywords: Altemeier’s operation; Delorme’s operation; Hospital Episode Statistics; Laparoscopic rectopexy; Rectal prolapse; Resection rectopexy
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: 16 Jun 2020 11:54
Last Modified: 26 Feb 2021 11:59
URI: https://eprints.keele.ac.uk/id/eprint/8069

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