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Health Ministry study finds complications in one-fifth of large-intestine operations; 9 percent die
By Dan Even

Preliminary findings from a Health Ministry study into surgical outcomes at Israeli hospitals point to unforeseen complications in more than 21 percent of operations involving the large intestine.

In recent years the ministry had refrained from ongoing evaluation of the outcomes of operations out of concern that the findings might cause panic among the public.
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According to the study, in 12 percent of operations involving the large intestine patients contracted infections following surgery, while in 13 percent there were complications that required treatment.

Nine percent of patients died in surgery, and there were complications in a total of 21 percent of the operations.

The preliminary results were presented at a conference held this weekend, sponsored by the Israel Society for Quality in Medicine.

They were based on 16,829 operations on the large intestine performed from 2004-2007 on adult patients at 24 general-service hospitals in Israel.

The study was conducted in cooperation with the Israel Surgical Association.

According to the Health Information Director of the ministry's Health Information and Computer Services Department, Ziona Haklai, who coordinated the data collection effort, "in all probability, the complication rate is even higher, because [the data] are based on hospital records only."

The evaluation of surgical outcomes at each hospital remains confidential, but the large intestine surgery death rate at one hospital was sufficiently high to prompt further investigation.

"Mortality rates from operations on the large intestine are explained by [the patients'] age, the type of operation, underlying disease and high-risk patients," Haklai noted.

She also noted the importance of better hospital record-keeping in identifying other complications, adding that "The database that was created is important because it enables the examination of trends over the course of years."

Additional data collection was carried out with the aim of create a comprehensive database on surgery performed in Israel.

The initial data relate to operations performed from 2001-2008 at general service hospitals.

They show that hernia repairs are the most common type of surgery in Israel, followed by appendectomies, exploratory surgery and gall bladder surgery.

The least-common operations are those on the liver and the pancreas.

The most complicated surgery, requiring hospitalization of more than two weeks, involves operations on the liver, pancreas and esophagus. There was been a small increase in appendectomies performed since 2004, the reasons for which the Health Ministry is investigating.

Unlike the data on surgical outcomes for operations on the large intestine, the broader statistical studies on surgery do not rely solely on the hospitals' own reporting. Rather, they include statistical sampling of records and follow-up phone calls to surgery patients following their discharge from the hospital.
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