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Session: ePoster Monitor 1-Benign Abdominal Disease 1

eP108 - Partial Resection vs Colectomy in the Setting of Major Lower Gastrointestinal Bleeding

Sunday, June 2, 2024
8:42 AM – 8:47 AM ET, USA
Location: Baltimore Convention Center, Room 318-320

    ePoster Presenter(s)

  • Nicholas C. Herold, DO

    General Surgery Resident
    UCF/ HCA Osceola Hospital
    University of Central Florida
    Orlando, FL, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • VC

    Victor Cabrera, MD

    Chief general surgery resident
    UCF/HCA Florida Osceola Hospital
    orlando, Florida, United States

    Disclosure information not submitted.

  • LS

    Luis F. Serrano, MD FACS

    Assitant professor surgery
    UCF
    kissimmee, Florida, United States

    Disclosure information not submitted.

  • PK

    Philip Kondylis, MD

    Colorectal Surgeon
    Colorectal Physicians and Surgeons of Pennsylvania
    Erie, Pennsylvania, United States

    Disclosure information not submitted.

Purpose/Background: Lower gastrointestinal bleeding (LGIB) is a commonplace cause for admission with surgeons playing a pivotal role in management after failure of medical and endoscopic intervention. In the setting of LGIB with associated hemodynamic instability, urgent total colectomy (TC) or partial colectomy (PC) of the affected segment provides a solution with a proven mortality benefit. The goal of this study is to assess the impact of total colectomy compared to partial colectomy intervention outcomes after LGIB.Methods/Interventions:

Methods: We performed a retrospective study from a prospectively accrued, de-identified Enterprise Level Clinical Database for patients with LGIB managed with total colectomy or partial colectomy from 2016-2021. Analysis included comparison of comorbidities, complications and clinical outcomes. The regression models controlled for age, gender, race, BMI and comorbidities compared TC and PC outcomes. Pediatric patients < 18 years old, mortality prior to surgical intervention, and elective colectomy were excluded from the study.Results/Outcomes:

Results: 5,618 patients with LGIB underwent surgical intervention after failure of nonoperative management. 5,392 patients underwent TC and 226 patients underwent PC. Patients that underwent a PC had an increased length of stay compared to TC (p < .0001). Patients that underwent a PC were 1.905 times more likely to be admitted to a SNF than those who underwent a TC (p=0.0002). There was no significant difference between 30-day readmission rates between TC and PC patients (p=0.4445). Patients who underwent PC were 5.134 times as likely to expire while hospitalized as those who underwent a TC. (p < 0.0001).Conclusion/

Discussion:

Conclusions: In the setting of major lower gastrointestinal bleeding PC was associated with a significant increase inpatient morbidity and mortality, length of stay and SNF admission rates without a difference in 30-day readmission rates. The data set suggests that approaching a major lower gastrointestinal bleed surgically with a segmental colectomy is associated with detrimental outcomes when compared with total colectomy.