W. I. McKinley1, B. Strollo1, M. Benns1, A. Motameni1, N. Nash1, M. Bozeman1, K. Miller1 1University Of Louisville,Department Of Surgery,Louisville, KENTUCKY, USA
Introduction: Enterectomy is a commonly performed procedure in trauma and acute care surgery but the term is nebulous in regard to the extent of bowel resected. There is wide variation in practice between intraoperative assessment of bowel length and the accuracy of that assessment is unknown. The aim of this study is to determine the accuracy and frequency of intraoperative assessment of bowel length.
Methods: After obtaining IRB approval retrospective chart review was performed of patients from three centers in Louisville, KY having undergone enterectomy (CPT codes 44120, 44202) from 2012-2016. Patients were excluded if lacking pathology or an operative report. Subgroups (0 to <10cm, 10 to <30cm, 30 to <50cm, and >50cm) were created based on length dictated by the operative surgeon. Groups were compared using a 2-tailed Student’s t-test.
Results: 174 patients were included in the study (219 bowel resections) of whom 106 did have an estimate of bowel length resected (48.4%). 24 patients had <10cm removed, 47 patients had 10-30cm removed, 18 patients had 30-50cm removed, and 17 patients had >50cm removed. Estimated bowel length <10cm showed a statistically significant underestimation in comparison to pathologic specimen, and larger resections tended to be overestimated.
Conclusion: Documentation regarding extent of bowel resected at our institution was poor, as surgeons dictated estimated length in less than half of cases. Surgeons underestimate short segment resections while overestimating on extensive (>50cm) enterectomy. Documentation of extent of enterectomy should be standardized and can have future clinical implications.
