Operative mortality following surgery for colorectal cancer

Abstract

From 1973 to 1986 at the Baviere Hospital, University of Liège, 476 patients underwent surgery for colorectal cancers. The overall operative mortality rate was 13.4 per cent. The following postoperative life-threatening complications occurred: myocardial infarction (14 per cent of the postoperative deaths) during the first three postoperative days; bronchopneumonia (27 per cent of the postoperative deaths) mainly during the first postoperative week; pulmonary embolism (17 per cent of the postoperative deaths) mainly during the second postoperative week; anastomotic leakage and cerebrovascular accident (14 and 8 per cent of the postoperative deaths respectively) mainly during the third and fourth postoperative weeks. Specific risk factors were chronic obstructive airways disease associated with a higher incidence of postoperative bronchopneumonia, and previous myocardial infarction associated with postoperative myocardial infarction and pulmonary embolism. General risk factors were old age and emergency procedure, both of which were associated with a higher incidence of infectious complications. The operative mortality rate fell from 20.1 per cent in the 1973-79 period to 7.8 per cent in the 1980-86 period.

Quality Control of Colorectal Surgery with an Extensive Complication Registration System

“…In our documented material, all possible clinical subtypes are included and anastomotic leakage appeared in 22 of the 353 operated patients (6%). The mortality rate after colon surgery in our study (7%) is comparable with the figures published in the literature (3–18%) [1,2,3, 5, 13]. …”

“…Colorectal surgery coincides with the occurrence of significant complications [1, 2]. Anastomotic bowel leakage and wound infection are complications most frequently observed in the postoperative phase [3].…”

Mortality after Colon Surgery: The Value of a Mortality Registration System

“…This is comparable to data in the literature where postoperative mortality varies from 5 to 13% [1, 6, 7, 11]. Also in case of the emergency surgery and age-related mortality, our data are in agreement with other reports [6, 7, 12].…”

“…Anastomotic leakage was one of the most important factors, causing postoperative death in 17%. This is also seen in other studies, where anastomotic leakage that led to death varies from 14 to 18% [7, 13, 14]. Despite this accordance with the literature, anastomotic leakage is something that has to be evaluated carefully.…”

“…Cohen et al [1]report an overall mortality of 5% with no deaths after elective surgery. Other reports demonstrated mortality percentages between 5 and 26% [2, 3, 4, 5, 6, 7]. Some of these reports demonstrated the difference in mortality between elective and emergency surgery.…”