Specialists best for emergency colon surgery

NEW YORK (Reuters Health) - If you find yourself in need of emergency colon surgery, you'll be better off with a surgeon who specializes in operating on the large intestine, a new study from Spain shows.

While colorectal surgery is a formally accepted specialty in the United States, Australia, and other regions, this is not yet the case in Europe, Dr. Sebastiano Biondo and colleagues from the University of Barcelona note. There is very little information, they add, on whether colorectal surgery specialists produce better results for their patients than general surgeons.

Emergency colon surgery may be performed to treat colorectal cancer, diverticulitis (pouch-like bulges in the intestine), lack of blood flow in the colon, and other problems. Such emergencies are life-threatening and carry a high risk of complications and death, Biondo and his team note in the Archives of Surgery.

To investigate whether specially trained surgeons might do a better job than general surgeons, Biondo and his team looked at 1,046 patients who underwent emergency colon surgery at their hospital between 1993 and 2006. Just over a third were operated on by a colorectal surgery specialist, while the rest were treated by a general surgeon.

Patients treated by colorectal surgery specialists were more likely than those treated by generalists to undergo single stage operations (rather than more complicated multiple-stage procedures).

Fifty-two percent of patients treated by specialists had complications after surgery, compared to 61 percent of those treated by general surgeons. Twenty-eight percent of patients treated by a general surgeon died after the surgery compared with 18 percent of those treated by a specialist. In 12 percent of patients treated by general surgeons, the repaired area of the colon re-opened, compared to 6 percent of those treated by specialists.

There were no differences between the two groups in the percentage of patients who needed additional surgery or the amount of time spent in the hospital after surgery.

Based on these findings, conclude the researchers, "we may need to encourage health authorities to organize emergency procedures in such a way that colorectal surgeons are in charge of handling colorectal emergencies."

SOURCE: Archives of Surgery, January 2010.