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April 11, 2026World Journal of Surgery0 citationsOpen Access

Patient Experience of Emergency Laparotomy: A Mixed Methods Study (The PEEL‐2 Study)

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LSLouise M. SilvaSMSarah A. MohammedPSPaula Strong

Key Result

Emergency laparotomy survivors experienced significant physical and psychological burdens, with 38.9% reporting incisional hernias and 34.0% expressing dissatisfaction with body image.

Key Points

  • The study aims to assess quality of life and patient-reported outcomes among survivors of emergency laparotomy.
  • Conducted a retrospective mixed-methods analysis of patients who underwent EmLap from 2016-2019.
  • Collected demographic and clinical data from the National Emergency Laparotomy Audit (NELA) databases.
  • Administered surveys regarding quality of life, employment, sexual function, and other factors.
  • Performed thematic analysis of qualitative responses and regression analysis for quantitative data.
  • Identified 725 eligible patients, with a 42.8% response rate from 310 completed surveys.
  • Mean follow-up length was 33 months, revealing QoL linked to higher socioeconomic status and reduced BMI.
  • 38.9% of respondents reported incisional hernias, and 34.0% indicated dissatisfaction with body image.
  • Free-text responses highlighted issues such as unmet mental health support and dietary guidance needs.

Study Design

Type

Observational (n=310)

Multicenter

No

Structured PICO

What are the long-term patient-reported outcomes and experiences among emergency laparotomy survivors?

P
Population
310 patients who underwent emergency laparotomy (EmLap) from 2016-2019 at a tertiary hospital (out of 725 eligible patients)
I
Intervention
Emergency laparotomy (observational survivorship)
O
Outcome
Quality of life (EQ-5D-5L) and patient-reported outcomes and experiences (PROMs and PREMs)patient reported

Emergency laparotomy survivors face significant physical, psychological, and socioeconomic burdens, highlighting the need for tailored post-operative support systems.

Abstract

ABSTRACT Background Emergency laparotomy (EmLap) is a high‐risk surgery for acute abdominal conditions. This study uses a retrospective mixed‐methods approach to explore quality of life and patient‐reported outcomes and experiences (PROMs and PREMs) among EmLap survivors. Methods Patients who underwent EmLap from 2016–2019 at a tertiary hospital were surveyed, with demographic and clinical data collected from institutional National Emergency Laparotomy Audit (NELA) databases. Outcomes included QoL (EQ‐5D‐5L), employment, sexual function, incisional hernias, peri‐operative anxiety, body image, and overall patient experience. The themes explored in the questionnaire were developed based on findings from previous studies of EmLap survivorship. Thematic analysis was conducted for qualitative responses, alongside statistical analysis for quantitative data. Results A total of 725 eligible patients were identified, and 310 responses were returned (42.8% response rate). Mean length of follow up was 33 months (range 6–54 months). Regression analysis confirmed QoL was associated with higher socioeconomic status (coefficient 0.047, p < 0.001), reduced BMI (coefficient −0.009, p < 0.05) and reduced ASA (coefficient −0.070, p < 0.05). Nearly half of respondents were retired at the time of surgery; among those who were employed, 40.5% experienced changes in employment which included earlier retirement. Recovery of sexual function was delayed, with 11.3% of patients reporting they had not resumed sexual activity post‐surgery. Incisional hernia was reported by 38.9% of respondents, and 34.0% expressed dissatisfaction with body image. Free‐text responses revealed unmet needs for mental health support (22.6%), dietary guidance (10.3%), and physiotherapy (15.8%). Conclusion These findings highlight the physical, psychological, and socioeconomic burden faced by patients after EmLap, and support the need for tailored post‐operative support systems to be integrated into post‐operative care.

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Cite This Study

Silva et al. (2026) conducted an observational in Emergency laparotomy survivors (n=310). Emergency laparotomy was evaluated on Quality of life (EQ-5D-5L) and patient-reported outcomes and experiences. Emergency laparotomy survivors experienced significant physical and psychological burdens, with 38.9% reporting incisional hernias and 34.0% expressing dissatisfaction with body image.

synapsesocial.com/papers/69d9e66378050d08c1b76bb3https://doi.org/10.1002/wjs.70342
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