Patterns and Outcomes of Elective Versus Nonelective Rectal Prolapse Repair: An American College of Surgeons National Quality Surgical Improvement Program Analysis.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος:	Patterns and Outcomes of Elective Versus Nonelective Rectal Prolapse Repair: An American College of Surgeons National Quality Surgical Improvement Program Analysis.
Συγγραφείς:	Alsayari R; Division of Colon and Rectal Surgery, Department of Surgery, Jewish General Hospital, Montreal, Québec, Canada., Cui Y; Center for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada., Pang AJ; Division of Colon and Rectal Surgery, Department of Surgery, Jewish General Hospital, Montreal, Québec, Canada., Ghitulescu GA; Division of Colon and Rectal Surgery, Department of Surgery, Jewish General Hospital, Montreal, Québec, Canada., Faria J; Division of Colon and Rectal Surgery, Department of Surgery, Jewish General Hospital, Montreal, Québec, Canada., Morin NA; Division of Colon and Rectal Surgery, Department of Surgery, Jewish General Hospital, Montreal, Québec, Canada., Vasilevsky CA; Division of Colon and Rectal Surgery, Department of Surgery, Jewish General Hospital, Montreal, Québec, Canada., Garfinkle R; Division of Colon and Rectal Surgery, Department of Surgery, Jewish General Hospital, Montreal, Québec, Canada.
Πηγή:	Diseases of the colon and rectum [Dis Colon Rectum] 2026 Oct 01; Vol. 69 (10), pp. 2492-2499. Date of Electronic Publication: 2026 Jul 16.
Τύπος έκδοσης:	Journal Article; Multicenter Study; Comparative Study
Γλώσσα:	English
Στοιχεία περιοδικού:	Publisher: Lippincott Country of Publication: United States NLM ID: 0372764 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1530-0358 (Electronic) Linking ISSN: 00123706 NLM ISO Abbreviation: Dis Colon Rectum Subsets: MEDLINE
Imprint Name(s):	Original Publication: Philadelphia. Lippincott
Ιατρικοί όροι (MeSH):	Colorectal Surgical Procedures/adverse effects , Colorectal Surgical Procedures/methods , Colorectal Surgical Procedures/statistics & numerical data , Elective Surgical Procedures/methods , Elective Surgical Procedures/statistics & numerical data , Elective Surgical Procedures/adverse effects , Postoperative Complications/epidemiology , Rectal Prolapse/surgery, Patient Readmission/statistics & numerical data ; Reoperation/statistics & numerical data ; United States/epidemiology ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Quality Improvement ; Retrospective Studies ; Treatment Outcome
Περίληψη:	Background: There is a paucity of knowledge regarding the presentation, surgical management, and short-term outcomes of rectal prolapse in the nonelective setting. Objective: The objectives of this study were to evaluate short-term postoperative outcomes after nonelective surgery for rectal prolapse and to compare those outcomes with those of patients who underwent elective repair. Design: Retrospective cohort study. Settings: Multicenter North American database. Patients: Adults (aged 18 years or older) who underwent surgery for rectal prolapse. Interventions: Nonelective surgery (vs elective surgery). Main Outcome Measures: Coprimary outcomes included 30-day postoperative morbidity, mortality, reoperation, and unplanned hospital readmission. Results: In total, 17,836 patients underwent surgery for rectal prolapse and were followed for 30 days postoperatively; 1636 (9.2%) underwent nonelective and 16,200 (90.8%) underwent elective surgery. Patients who underwent nonelective surgery were older (age 85 years and older: 29.5% vs 13.9%, p < 0.001), more likely to be functionally dependent (16.8% vs 6.3%, p < 0.001), and were more likely to undergo a perineal approach (59.7% vs 40.7%, p < 0.001) than those who underwent elective surgery. On multiple logistic regression, nonelective surgery was independently associated with 30-day postoperative morbidity (adjusted OR 2.16; 95% CI, 1.87-2.48), mortality (adjusted OR 2.97; 95% CI, 2.10-4.14), reoperation (adjusted OR 1.89; 95% CI, 1.49-2.39), and unplanned hospital readmission (adjusted OR 1.87; 95% CI, 1.57-2.20). Furthermore, when stratified by surgical approach (perineal vs abdominal), nonelective surgery remained associated with a similar increase in postoperative risk across all outcomes. Among 1636 nonelective cases, 237 (14.5%) underwent emergent surgery and 1399 (85.5%) underwent nonemergent (or urgent) surgery. Compared with nonemergent surgery, emergent surgery for rectal prolapse was associated with an incrementally higher risk of 30-day postoperative morbidity (25.7% vs 19.6%, p = 0.030) and mortality (6.3% vs 3.3%, p = 0.022). Limitations: No data are available on previous repairs and/or hospital visits related to rectal prolapse. Conclusions: Nonelective rectal prolapse surgery was associated with significantly worse 30-day postoperative outcomes compared with elective repair. See Video Abstract . Patrones Y Resultados De La Reparacin Electiva Frente a La No Electiva Del Prolapso Rectal Un Anlisis Del Acsnsqip: ANTECEDENTES:Existe escasa información sobre la presentación clínica, el tratamiento quirúrgico y los resultados a corto plazo del prolapso rectal en casos no electivos.OBJETIVO:Los objetivos de este estudio fueron evaluar los resultados postoperatorios a corto plazo tras la cirugía no electiva para el prolapso rectal y compararlos con los de pacientes sometidos a cirugía electiva.DISEÑO:Estudio de cohorte retrospectivo.ÁMBITO:Base de datos multicéntrica norteamericana.PACIENTES:Adultos (mayores de 18 años) sometidos a cirugía por prolapso rectal.INTERVENCIONES:Cirugía no electiva (frente a cirugía electiva).PRINCIPALES MEDIDAS DE RESULTADO:Los resultados coprimarios incluyeron la morbilidad, la mortalidad, la reintervención y el reingreso hospitalario no planificado a los 30 días del postoperatorio. RESULTADOS: En total, 17.836 pacientes fueron intervenidos quirúrgicamente por prolapso rectal y se les realizó un seguimiento durante 30 días después de la operación: 1.636 (9,2 %) no electivos y 16.200 (90,8 %) electivos. Los pacientes que se sometieron a cirugía no electiva eran mayores (85 años o más: 29,5 % frente a 13,9 %, p < 0,001), tenían más probabilidades de ser funcionalmente dependientes (16,8 % frente a 6,3 %, p < 0,001) y tenían más probabilidades de someterse a un abordaje perineal (59,7 % frente a 40,7 %, p < 0,001). En el análisis de regresión logística múltiple, la cirugía no electiva se asoció de forma independiente con la morbilidad postoperatoria a los 30 días (OR ajustado: 2,16; IC del 95%: 1,87-2,48), la mortalidad (OR ajustado: 2,97; IC del 95%: 2,10-4,14), la reintervención (OR ajustado: 1,89; IC del 95%: 1,49-2,39) y el reingreso hospitalario no planificado (OR ajustado: 1,87; IC del 95%: 1,57-2,20). Además, al estratificar por abordaje quirúrgico (perineal frente a abdominal), la cirugía no electiva siguió asociada a un aumento similar del riesgo postoperatorio en todos los resultados. Entre 1636 casos no electivos, 237 (14,5 % de los casos no electivos) se sometieron a cirugía de urgencia y 1399 (85,5 % de los casos no electivos) a cirugía no urgente. En comparación con la cirugía no urgente, la cirugía de urgencia para el prolapso rectal se asoció con un riesgo incrementalmente mayor de morbilidad postoperatoria a los 30 días (25,7 % frente a 19,6 %, p = 0,030) y mortalidad (6,3 % frente a 3,3 %, p = 0,022).LIMITACIONES:No se dispone de datos sobre reparaciones previas ni visitas hospitalarias relacionadas con el prolapso rectal.CONCLUSIONES:La cirugía no electiva para el prolapso rectal se asoció con resultados postoperatorios a los 30 días significativamente peores en comparación con la reparación electiva. (AI-generated translated ). (Copyright © The ASCRS 2026.)
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Contributed Indexing:	Keywords: Nonelective surgery; Postoperative outcomes; Rectal prolapse; Repair
Entry Date(s):	Date Created: 20260716 Date Completed: 20260916 Latest Revision: 20260930
Update Code:	20260930
DOI:	10.1097/DCR.0000000000004365
PMID:	42461067
Βάση Δεδομένων:	MEDLINE

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ISSN:	1530-0358
DOI:	10.1097/DCR.0000000000004365