Analysis of 230 Cases of Emergent Surgery for Obstructing Colon Cancer—Lessons Learned
Purpose We aimed to identify prognostic factors affecting clinical outcomes in emergent primary resection. Methods A retrospective analysis of prospectively acquired data of 230 consecutive emergent patients between August 1994 and January 2005 were evaluated in this study. Sixty-nine patients appli...
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Published in: | Journal of gastrointestinal surgery Vol. 15; no. 1; pp. 110 - 119 |
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Main Authors: | , , , |
Format: | Journal Article |
Language: | English |
Published: |
New York
Springer-Verlag
2011
Springer Nature B.V |
Subjects: | |
Online Access: | Get full text |
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Summary: | Purpose
We aimed to identify prognostic factors affecting clinical outcomes in emergent primary resection.
Methods
A retrospective analysis of prospectively acquired data of 230 consecutive emergent patients between August 1994 and January 2005 were evaluated in this study. Sixty-nine patients applied with right colon obstruction and 161 patients with left. Resection and primary anastomosis was carried out in 128 patients and resection and stoma in 102 patients. The patients were divided into two cohorts: patients who developed poor outcome within 30 days after surgery and those who did not.
Results
Major morbidity or mortality were reported in 60 (26.1%) patients. Analysis revealed that the most important prognostic factors for poor outcome were American Anesthesiology Association (ASA) grade ≥3, Acute Physiology and Chronic Health Evaluation II (APACHE II) score ≥11, age >60 years, presence of peritonitis, and surgery during on-call hours. Age >60 years and on-call surgery were determinant factors in right-sided obstructions, whereas ASA grade ≥3, APACHE II score ≥11, and presence of peritonitis were determinant factors in left-sided obstructions.
Conclusions
All these factors but the timing of the operation emphasize the pivotal role of the patient’s physiological condition on admission. Accurate preoperative evaluation might predict the clinical outcome and help in establishing the most appropriate treatment |
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Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 |
ISSN: | 1091-255X 1873-4626 |
DOI: | 10.1007/s11605-010-1360-2 |