Comparing return of bowel function after right versus extended right hemicolectomy: a retrospective analysis.

BACKGROUND: Prolonged postoperative ileus (PPOI) is associated with higher morbidity and extended inpatient stay. Although evidence suggests that PPOI is more common following right-sided resections, it is uncertain if return to bowel function is similar following extended right (ERH) versus right hemicolectomy (RH). METHODS: The recovery of patients undergoing ERH and RH in a regional hospital in New Zealand was retrospectively compared, from 2012 to 2021. Rates of PPOI, return of bowel function and postoperative complications were compared. Other factors potentially relating to PPOI were analysed. RESULTS: 293 patients were included (42 who underwent ERH, and 251 RH). PPOI was more common following ERH than RH (43% vs. 25%, P = 0.02). When accounting for the operative approach, rate of PPOI was not significantly different (42% open ERH vs. 36% open RH; P = 0.56). Excluding PPOI, return of bowel function did not differ between groups. Patient undergoing ERH versus RH had significantly higher length of stay (1 day) and Hb drop (2.5 g/L) postoperatively. CONCLUSION: Higher rates of PPOI have been demonstrated in ERH versus RH however when controlling for approach, there was not a significant difference. Further interrogation into rates of PPOI (particularly after laparoscopic surgery) are warranted to tailor locoregional ERAS protocols.

Timing of emergency caesareans - what's the rush? A retrospective multi-centred observational study into decision-to-delivery interval and maternal and fetal outcomes.

This study primarily aims to investigate the relationship between decision-to-delivery interval (DDI) and fetal and maternal outcomes in patients undergoing an emergency caesarean section. A secondary aim was to investigate if any maternal or labour features adversely affected outcomes. Two-hundred and forty-six patients underwent an emergency caesarean section within a 9 month period. Outcomes considered included estimated blood loss, need for special care baby unit admission, need for neonatal resus in the form of continuous positive airway pressure and initial APGARs. A multivariate regression analysis was used. This study found no relation between DDI and outcomes.