Analyse der postoperativen Todesf�lle beim Colon- und Rectumcarcinom

Schulz, Uwe; Drüner, H. U.; Lang, H.

doi:10.1007/bf01267991

Cited by 4 publications

(4 citation statements)

References 14 publications

(24 reference statements)

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“…Postoperative complications differed from department to department, and departments performing delayed tumor resection in emergency cases had better overall results. In another study of 200 deaths following surgery for colorectal cancer [8], pneumonia (24.5%) was found to be the most common cause of death and this was followed by peritonitis (22%), pulmonary embolism (15.5%), advanced tumor stage (14%) and cardiac failure (9.5%). Non-surgical causes of death thus seem to be more common [2,7,8] than causes of death directly related to the surgery itself.…”

Section: Discussionmentioning

confidence: 97%

“…In another study of 200 deaths following surgery for colorectal cancer [8], pneumonia (24.5%) was found to be the most common cause of death and this was followed by peritonitis (22%), pulmonary embolism (15.5%), advanced tumor stage (14%) and cardiac failure (9.5%). Non-surgical causes of death thus seem to be more common [2,7,8] than causes of death directly related to the surgery itself. In the present study 20% of patients developing pulmonary embolism and nearly 50% of patients suffering myocardial infarction, congestive heart failure, stroke, and ARDS died during the postoperative period.…”

Section: Discussionmentioning

confidence: 97%

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Operative mortality in colorectal surgery

Isbister

1997

Coloproctol

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Summary, Our aim was to examine all postoperative deaths in a colorectal surgical service. We retrospectively examined the records of patients dying within 30 days of surgery in the Colorectal Service, Wellington School of Medicine, New Zealand. There were 16 males (74.4 years) and 17 females (71.9 years). Nineteen patients were admitted during winter. Twenty-one patients underwent emergency operations. Consultants performed 26 operations. Perioperative blood transfusion was needed in 23 patients. Five patients died following surgery for colorectal perforation (! 1.6%). Major bleeding from the colon of rectum was the next commonest indication for surgery in those patients dying postoperatively (8.2%). The disease site was situated in or distal to the sigmoid colon in 22 patients. The postoperative mortality was lowest following right hemicolectomy (0.9%). Patients undergoing colonic bypass surgery had the highest postoperative mortality (12.5%). Patients with ischaemic or radiation-induced disease had high mortality rates (12.5%). 20% of patients suffering pulmonary embolism, 44.4% myocardial infarction, 43.8% congestive heart failure, 50.0% stroke, and 50.0% ARDS died postoperatively. Two patients died within 48 hours of surgery but the remaining deaths occurred after at least 5 days. In patients witb abdominal sepsis of compromised colonic blood flow the avoidance of anastomoses and the performance of peritoneal lavage may contribute to survival. In all other patients mortality is primarily determined by coexistent medical disease.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 97%

Operative mortality in colorectal surgery

Isbister

1997

Coloproctol

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“…Knowledge of the incidence and risk factors for specific disease entity may improve knowledge of mortality and morbidity risks associated with a particular pathology and surgery. Therefore, special attention is needed to identify peculiar characteristics of EPSBO after colectomy for cancer, considering that EPSBO may be a contributor for increasing the mortality risk after colectomy [8]. However, to date, there has been only limited information on crude features of EPSBO after colectomy [2, 4, 7].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Early Postoperative Small‐Bowel Obstruction After Colectomy in Colorectal Cancer

Shin

Hong

2008

World j. surg.

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It seems that pelvic surgeries do not have a higher rate of EPSBO compared with colonic surgeries. Local remnant tumor and poor systemic condition seems to be independent risk factors for EPSBO after colectomies for colorectal cancer, especially with pelvic surgery. These findings suggest that particular attention is needed to reduce the rate of EPSBO in patients who undergo colectomies for colorectal cancer.

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“…In particular, early postoperative small bowel obstruction (EPSBO) developing within 4 weeks following surgery [8, 9] has been associated with increased hospital stays, postoperative adjuvant treatment delays, and mortality [10, 11]. Nevertheless, little information is available regarding EPSBO other than the facts that it has a reported incidence of approximately 7% after a proctectomy [12, 13] and that rectal surgery and poor systemic conditions contribute to the risk of EPSBO [12, 13].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors of Early Postoperative Small Bowel Obstruction Following a Proctectomy for Rectal Cancer

Shin

2011

J Korean Soc Coloproctol

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PurposePostoperative small bowel obstruction is a common and serious complication following a proctectomy, and early postoperative small bowel obstruction (EPSBO) leads to longer hospital stays, delays chemotherapy in advanced cases, and may be a contributor to mortality. The goal of this study is to identify the risk factors of EPSBO after a proctectomy for rectal cancer, thereby seeking to reduce the incidence of EPSBO.MethodsPatients (735) who underwent a proctectomy for rectal cancer between March 2005 and February 2010 were entered into this study, and data were collected prospectively. Patients were judged to have EPSBO if, within the first 30 days, they presented symptoms such as nausea, vomiting and abdominal distention lasting for 2 days, and radiologic finding of small bowel obstruction after evidence of return of small bowel motility. The association between EPSBO and patients and surgery-related variables were studied by using univariate and multivariate analyses.ResultsEPSBO developed in 47 cases (6.4%) and was the most frequently occurring complication in the early perioperative period following a proctectomy. The frequency of EPSBO according to operative variables shows that EPSBO developed in 3.0% of the patients who underwent laparoscopic surgery (LS) compared with 8.4% of the patients who underwent open surgery (OS) (P = 0.004). OS (odds ratio [OR], 2.5) and a previous laparotomy (OR, 2.3) were independent risk factors for the development of EPSBO after a proctectomy for rectal cancer.ConclusionEPSBO is more likely to occur in patients who undergo OS or who have had a previous laparotomy. LS may be considered as a surgical procedure that can reduce the risk of EPSBO in patients undergoing a proctectomy for rectal cancer.

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Analyse der postoperativen Todesf�lle beim Colon- und Rectumcarcinom

Cited by 4 publications

References 14 publications

Operative mortality in colorectal surgery

Operative mortality in colorectal surgery

Risk Factors for Early Postoperative Small‐Bowel Obstruction After Colectomy in Colorectal Cancer

Risk Factors of Early Postoperative Small Bowel Obstruction Following a Proctectomy for Rectal Cancer

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