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Bowel patients 'need more surgery'

Patients who have undergone a bowel operation could be five times more likely to need further emergency surgery depending on which hospital treats them, research suggests.

There are wide variations around England in the rates at which people need operating on again once they have undergone surgery, experts said.

The research, published in the British Medical Journal, found unplanned re-operation rates were five times higher in some hospitals - prompting concerns about the performance of individual surgeons and NHS trusts.

Experts at Imperial College London used statistics for 246,469 patients treated in 175 English hospital trusts who underwent bowel resection surgery for the first time between 2000 and 2008.

Bowel resection involves removing part of the bowel and joining the two ends together, and is used for conditions such as bowel cancer, bad cases of Crohn's disease, blockages in the bowel and scarring.

Of the group, 15,986 (6.5%) patients needed further surgery within 28 days, including of the bowel, to control bleeding or for complications arising from their wound. Most of these patients (83%) underwent emergency surgery while still in hospital while the remainder ended up being readmitted.

Analysis showed that patients who had gone in for emergency surgery in the first place had slightly higher re-operation rates than those whose surgery was planned (7% versus 6.2%).

Men and people with inflammatory bowel disease such as colitis and Crohn's, or other pre-existing conditions, were also more likely to need emergency surgery.

For those whose original surgery was planned, there was a five-fold difference in highest and lowest re-operation rates (14.9% compared to 2.8%) among trusts performing more than 500 procedures during the study.

A Department of Health spokesman said: "NHS trusts need to get it right first time and prevent avoidable readmissions, so patients get better care and the health service will become more efficient. Publishing data gives patients a voice and provides the NHS with vital insight into their views on the effectiveness of the care they receive. It also means trusts can see how they fare against others so they can take action and strive to be among the best."


From Belfast Telegraph