Unplanned return to the operating theatre in gynaecology: five years’ experience

Mahfouz, Ismaiel Abu; Asali, Fida; Wiltshire, Rebecca; Sayer, Timothy R.; Phillips, Christian

doi:10.1016/j.ejogrb.2011.03.019

Cited by 7 publications

(12 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Post-operative bleeding is an urgent and life-threatening complication that often needs emergent surgical treatment. It is also one of the major indications that causes UROR in different surgeries (7,8). Our study showed that bleeding accounted for over 80% of the UROR for lung cancer surgeries.…”

Section: Discussionmentioning

confidence: 59%

Bleeding is the most common cause of unplanned return to operating room after lung cancer surgeries

Li¹,

Xue²,

Gao³

et al. 2020

J Thorac Dis

View full text Add to dashboard Cite

Background: The rate of unplanned return to the operation room (UROR) is an important index for the quality of surgeries. Study of the features and causes of patients who have suffered UROR is key to reduce the risk of it. Methods: A retrospective, observational study was conducted among lung cancer patients who have received lung resections and UROR over a 5-year period. The causes, findings, procedures of UROR and recovery of patients were examined. Results: Among the 23,345 lung cancer surgeries, 64 underwent UROR with the rate being 0.27%.Lobectomy was performed in 78.1% of the patients. The most common indication was post-operative bleeding, responsible for 82.8% (53/64) of the cases. The median length of stay after the second surgery was 7 days and over 90% of the patients were discharged with proper recovery. The death rate within 90 days after return to operation room (OR) was 1.6% (1/64). In the 53 cases caused by bleeding, 27 (50.9%) occurred in surgical sites, with the raw surface of lymph node dissection being most frequently affected.Bleedings on incisions and unknown origin took up 11.3% and 37.7%, respectively. Conclusions: Bleeding is the most common indication which causes over 80% of UROR for lung cancer surgeries. Careful examination and complete hemostasis in surgery is key to reduce the risk of this unwanted complication.

show abstract

Section: Discussionmentioning

confidence: 59%

Bleeding is the most common cause of unplanned return to operating room after lung cancer surgeries

Li¹,

Xue²,

Gao³

et al. 2020

J Thorac Dis

View full text Add to dashboard Cite

show abstract

“…In one study, the primary reason for emergency exploratory laparotomy in the obstetrics and gynecology department was severe or persistent postoperative bleeding. 9 In the present study, the primary abnormal signs exhibited by patients returning to the ward were vaginal hemorrhage and persistent or excessive postpartum hemorrhage, resulting in different degrees of hemorrhagic shock as well as coagulation dysfunction in some cases. Ineffective conservative treatment and immediate danger to the patient’s life are the main surgical indications for emergency exploratory laparotomy.…”

Section: Discussionmentioning

confidence: 56%

“…In one study, the primary reason for emergency exploratory laparotomy in the obstetrics and gynecology department was severe or persistent postoperative bleeding. 9 In the When conservative treatments fail to control these symptoms, a hemostatic operation or emergency hysterectomy is often essential to preserve the life of the mother. After undergoing a hysterectomy, however, women of reproductive age may experience both physical and psychological discomfort, leading to a reduction in quality of life.…”

Section: Discussionmentioning

confidence: 99%

Clinical analysis of emergency exploratory laparotomy in patients with intractable postpartum hemorrhage

Chen¹,

Wu²,

Han³

et al. 2019

J Int Med Res

View full text Add to dashboard Cite

Objective This study was performed to explore the causes and clinical characteristics of emergency exploratory laparotomy in patients with intractable postpartum hemorrhage. Methods This retrospective study was performed from January 2004 to December 2017. Patients with intractable postpartum hemorrhage were grouped according to the initial pathogenesis as determined by exploratory laparotomy: uterine atony, placental factors, coagulation dysfunction, or uterine rupture. Results This study involved 72 patients who underwent emergency exploratory laparotomy, accounting for 0.04% of total deliveries. Uterine preservation surgery and hysterectomy were performed in 31 and 41 patients, respectively. Abnormal events upon returning to the ward were primarily vaginal hemorrhage and pelvic hematoma. The frequency of uterine artery ligation was lower in the hysterectomy group than uterine preservation group. The prothrombin activity level, fibrinogen level, and platelet count before surgery were lower in the hysterectomy group than uterine preservation group. The international normalized ratio and activated partial thromboplastin time were higher in the hysterectomy group than uterine preservation group. In total, 44 patients developed complications. Conclusion Placental implantation is a primary cause of hysterectomy after emergency laparotomy. However, the possibility of postpartum hemorrhage caused by coagulation disorders should not be ignored.

show abstract

“…There are several studies described in the literature, which have monitored unplanned returns to theatre as a trigger tool to improve surgical outcomes (Marini et al, 2012;Mahfouz et al, 2011;Ploeg et al, 2008;Kroon et al, 2007;Birkmeyer et al, 2001;Mukerji et al, 2012). It has shown to be an indicator of quality of care (Ploeg et al, 2008;Kroon et al, 2007) and additionally has identified patient pre-warning signs for re-operation (Mahfouz et al, 2011).…”

Section: Inadvertent Returns To Theatre Within 30 Days (Irt30) Of Surmentioning

confidence: 97%

“…It has shown to be an indicator of quality of care (Ploeg et al, 2008;Kroon et al, 2007) and additionally has identified patient pre-warning signs for re-operation (Mahfouz et al, 2011). Reports show that the analysis is useful not only for monitoring quality across hospitals but also highlights areas for local improvement (Birkmeyer et al, 2001;Mukerji et al, 2012).…”

Section: Inadvertent Returns To Theatre Within 30 Days (Irt30) Of Surmentioning

confidence: 99%

Inadvertent returns to theatre within 30 days (IRT30) of surgery

Sukha

Sykes

et al. 2015

Clinical Governance: An International Journal

View full text Add to dashboard Cite

Purpose – When a patient unexpectedly has to go back to the operating theatre, there is often a perceived problem with the primary operation. An IRT30 is defined as any patient returning to the operating theatre within 30 days of the index procedure. IRT30 has been suggested to be a useful quality indicator of surgical standards and surgeon performance. The purpose of this paper is to evaluate the usefulness of this validated tool, by assessing all IRT30 over a 12-month period. Learning points for individual surgeons, surgical subspecialty units and the clinical governance leads were reviewed. Design/methodology/approach – Consecutive series of general and vascular surgical patients undergoing elective and emergency procedures between July 2012 and 2013. Prospective data collection of all IRT30s classified as Types 1-5 by a single-rater and in-depth discussion of Types 3-5 cases at the clinical governance meetings. The individual case learning points were recorded and the collective data monitored monthly. Findings – There were 134 IRT30s. In total 84 cases were discussed: Type 3 (n=80), Type 4 (n=4) and Type 5 (n=0). In total 50 cases were not discussed: Type 1 (n=27), Type 2 (n=23). Originality/value – It is crucial that surgeons continue to learn throughout their surgical career by reflecting on their own and their colleague’s results, complications and surgical performance. Analysing Types 3 and 4 IRT30s within the governance meetings has identified learning points related to both surgical technique and surgical decision making. By embracing these learning points, surgical technique and individual as well as group surgeon performance can be modified and opportunities for training and focused supervision created.

show abstract

Unplanned return to the operating theatre in gynaecology: five years’ experience

Cited by 7 publications

References 13 publications

Bleeding is the most common cause of unplanned return to operating room after lung cancer surgeries

Bleeding is the most common cause of unplanned return to operating room after lung cancer surgeries

Clinical analysis of emergency exploratory laparotomy in patients with intractable postpartum hemorrhage

Inadvertent returns to theatre within 30 days (IRT30) of surgery

Contact Info

Product

Resources

About