Rectal Prolapse Surgery in Switzerland: Hospital Volume and Patient Outcomes

Adult patients aged 20 years or older who underwent elective surgery for rectal prolapse in Switzerland between 2013 and 2022. The cohort includes patients treated by abdominal rectopexy, Delorme's procedure, perineal stapled prolapse resection, or Altemeier's procedure. Postoperative outcomes were evaluated according to annual hospital procedure volume. All surgical procedures were performed as part of routine clinical care without study-assigned interventions.

Procedure: Surgical Treatment of Rectal Prolapse

Patients underwent elective surgical treatment for rectal prolapse as part of routine clinical care. Procedures included abdominal rectopexy (open, laparoscopic, or robotic), Delorme's procedure, perineal stapled prolapse resection (PSP), and Altemeier's procedure. Surgical approaches were identified using Swiss CHOP procedure codes. No interventions were assigned by the investigators, as this was a retrospective observational study.

Plazo: During the index hospitalization, from admission until hospital discharge or in-hospital death. As data from the Federal statistical office was completely anonymised no longer follow-up was possible. Mean length of stay was 7 days.

In-hospital mortality was defined as death from any cause during the index hospitalization following elective rectal prolapse surgery. Mortality was assessed using anonymized inpatient data from the Swiss Federal Statistical Office and analysed in relation to annual hospital procedure volume.

Plazo: During the index hospitalization, from admission until hospital discharge or in-hospital death. As data from the Federal statistical office was completely anonymised no longer follow-up was possible. Mean length of stay was 7 days.

Occurrence of postoperative complications during the index hospitalization following elective rectal prolapse surgery. Complications were identified using predefined ICD-10 and CHOP codes from the Swiss national inpatient database.

Plazo: During the index hospitalization, from admission until hospital discharge or in-hospital death. As data from the Federal statistical office was completely anonymised no longer follow-up was possible. Mean length of stay was 7 days.

Failure-to-rescue was defined as in-hospital death following at least one major postoperative complication. The rate was calculated as the proportion of patients with major complications who died during the index hospitalization.

Plazo: During the index hospitalization, from admission until hospital discharge or in-hospital death. As data from the Federal statistical office was completely anonymised no longer follow-up was possible. Mean length of stay was 7 days.

Duration of the index hospitalization, measured in days. Length of stay was assessed using administrative inpatient data.

Mortality After Rectal Prolapse Surgery in Switzerland: a Nationwide Population-based Analysis of Hospital Volume and Shorterm Outcomes (2013-2022)