Emergency Bowel Key-Hole Surgery

Throughout England and Wales, there is an estimated 30,000 people who underwent emergency bowel "key-hole" surgery from  December 2014 until November 2015, this is according to the National Emergency Laparotomy Audit ("NELA") report released on 5 July 2016. The NELA was commissioned in 2012 by the Healthcare Quality Improvement Partnership with the specific aim of improving the quality of care to patients receiving emergency bowel key-hole surgery. 

The report has also highlighted that the mortality rate of patients at one month is 15% which, is the equivalent of 4,500 deaths within one month from the surgery. Key-hole surgery in itself presents inherent risks and complications while emergency bowel surgery is complex, requiring collaboration between specialities from multiple emergency departments. Since the conception of the NELA is has been observed that communication between departments has improved and this is reflected in the reduction in mortality rates.

In response to the findings in this report, the President of the Royal College of Surgeons, Miss Clare Marx, said: 

"Although standards of care for these seriously ill patients are getting better, there is still much room for improvement and it needs to be done quickly".

"As a priority, the NHS should look at access to critical care after surgery for these high risk patients. We already know that where these patients are receiving high dependency or intensive care after surgery they have better outcomes.  This audit reported 39% of patients were not admitted directly to a critical care unit after surgery."

There will almost certainly be risks associated with any invasive surgery nevertheless, one may draw comfort in the knowledge that organisations, such as the NELA, are being created for the improvement our healthcare systems. 

his article was written by Jason Squire.

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