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
Main Authors: Aslar, Ahmet Kessaf, Özdemir, Süleyman, Mahmoudi, Hatim, Kuzu, Mehmet Ayhan
Format: Journal Article
Language:English
Published: New York Springer-Verlag 2011
Springer Nature B.V
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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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ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-010-1360-2