Colorectal Resection

Colorectal Resection

Cleveland Clinic’s Colorectal Surgeons perform more than 3200 in-patient cases per year, in addition to many outpatient and endoscopic cases. These range from the routine to the most complex cases, including high volumes of colon and rectal cancer, surgery for Crohn’s disease and ulcerative colitis, diverticular disease, familial colorectal cancers and polyps, and referrals and transfers for management of complications or re-operative surgery. An enterprise based, multi-disciplinary approach including gastroenterologists, oncologists, radiology, nursing and other specialists, is utilized to best care for and treat patients. Surgeons participate in multi-disciplinary tumor board and inflammatory bowel disease conferences to provide the best evidence-based, individualized patient management.

In addition, Cleveland Clinic's rectal cancer program has earned a three-year accreditation from the National Accreditation Program from Rectal Cancer (NAPRC), a program launched in 2017 and administered and awarded by the American College of Surgeons (ACS).

Colorectal Surgery ACS NSQIP Outcomes

2019

The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) objectively measures and reports risk-adjusted surgical outcomes based on a defined sampling and abstraction methodology. These outcomes data reflect Cleveland Clinic’s overall colorectal surgery ACS NSQIP performance benchmarked against 699 participating sites.

Colorectal Surgery (699 Sites)NObservedExpected
30 Day Mortalityᵃ11030.73%2.00%
30 Day Morbidity110313.96%16.14%
Length of Stay*90322.92%21.61%
Cardiac11030.63%1.08%
Pneumoniaᵃ11030.82%1.63%
Unplanned Intubation11021.00%1.32%
Ventilator > 48 Hours10921.47%1.53%
Deep Vein Thrombosis (DVT) / Pulmonary Embolusᵇ11033.08%1.94%
Renal Failure11022.36%1.52%
Urinary Tract Infection (UTI)11031.36%1.77%
Surgical Site Infection (SSI)10918.98%9.57%
Sepsis10644.70%3.70%
C.diff Colitis11030.82%0.73%
Return to Operating Room (ROR)11034.62%5.65%
Readmissionᵇ110315.23%12.46%

American College of Surgeons National Surgical Quality Improvement Program, 2020.
ACS NSQIP® Semiannual Report July 23, 2020, Chicago: American College of Surgeons.

ᵃIdentified as a statistical outlier (lower than expected) by the ACS NSQIP hierarchical model.
ᵇIdentified as a statistical outlier (higher than expected) by the ACS NSQIP hierarchical model.

*LOS is defined as longer than the 75th percentile length-of-stay. For the NSQIP January 2020 SAR period, a Colorectal LOS event was defined as a LOS >6 days.

Colectomy ACS NSQIP Outcomes

2019

The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) objectively measures and reports risk-adjusted surgical outcomes based on a defined sampling and abstraction methodology. These outcomes data reflect Cleveland Clinic’s overall colectomy ACS NSQIP performance benchmarked against 336 participating sites.

Colectomy (336 Sites)NObservedExpected
30 Day Mortalityᵃ8420.83%2.28%
30 Day Morbidity84211.76%14.14%
Cardiac8420.71%1.13%
Pneumonia8420.71%1.64%
Unplanned Intubation8410.95%1.53%
Ventilator > 48 Hours8311.56%1.79%
Deep Vein Thrombosis (DVT) / Pulmonary Embolus8423.09%2.08%
Renal Failure8422.61%1.60%
Urinary Tract Infection (UTI)8420.95%1.36%
Surgical Site Infection (SSI)8346.83%7.37%
Sepsis8043.73%3.00%
C.diff Colitis8420.83%0.90%
Return to Operating Room (ROR)8423.68%4.95%
Readmission84213.42%11.47%
Anastomotic Leak8421.31%2.48%
Prolonged NPO/NGT Use84216.86%15.92%

American College of Surgeons National Surgical Quality Improvement Program, 2020.
ACS NSQIP® Semiannual Report July 23, 2020, Chicago: American College of Surgeons.

ᵃIdentified as a statistical outlier (lower than expected) by the ACS NSQIP hierarchical model

Proctectomy ACS NSQIP Outcomes

2019

The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) objectively measures and reports risk-adjusted surgical outcomes based on a defined sampling and abstraction methodology. These outcomes data reflect Cleveland Clinic’s overall proctectomy ACS NSQIP performance benchmarked against 193 participating sites.

Proctectomy (193 Sites)NObservedExpected
30 Day Mortality2610.38%1.28%
30 Day Morbidity26121.07%23.68%
Cardiac2610.38%0.81%
Pneumonia2611.15%1.48%
Ventilator > 48 Hours2611.15%0.70%
Deep Vein Thrombosis (DVT) / Pulmonary Embolus2613.07%1.84%
Renal Failure2601.54%0.89%
Urinary Tract Infection (UTI)2612.68%3.44%
Surgical Site Infection (SSI)25715.95%14.64%
Sepsis2607.69%5.25%
Readmission26121.07%17.68%
Anastomotic Leak2610.77%2.17%
Prolonged NPO/NGT Use26118.77%20.86%

American College of Surgeons National Surgical Quality Improvement Program, 2020.
ACS NSQIP® Semiannual Report July 23, 2020, Chicago: American College of Surgeons.