Risk factors for mortality–morbidity after emergency–urgent colorectal surgery

Skala, Karel; Gervaz, Pascal; Buchs, Nicolas; Inan, İbrahim; Secic, Michelle; Mugnier-Konrad, Béatrice; Morel, Philippe

doi:10.1007/s00384-008-0603-0

Cited by 49 publications

(49 citation statements)

References 26 publications

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“…Four patients were surgically treated with success, and one died. These results compare favorably to the outcomes after emergent colectomy in general (mortality, 14 %; morbidity, 36 %) [25] and specifically for LGIB with a mortality rate that can be as high as 27 % [8].…”

Section: Discussionmentioning

confidence: 68%

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Transarterial embolization in acute colonic bleeding: review of 11 years of experience and long-term results

Rossetti

Buchs

Bréguet

et al. 2012

Int J Colorectal Dis

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Background Lower gastrointestinal bleeding represents 20 % of all gastrointestinal bleedings. Interventional radiology has transformed the treatment of this pathology, but the long-term outcome after selective embolization has been poorly evaluated. The aim of this study is thus to evaluate the short-term and long-term outcomes after selective embolization for colonic bleeding.Methods From November 1998 to December 2010, all acute colonic embolizations for hemorrhage were retrospectively reviewed and analyzed. The risk factors for post-embolization ischemia were also assessed. Results Twenty-four patients underwent colonic embolization. There were 6 men and 18 women with a median age of 80 years (range, 42-94 years). The underlying etiologies included diverticular disease (41.9 %), post-polypectomy bleeding (16.7 %), malignancy (8.2 %), hemorrhoid (4.1 %), and angiodysplasia (4.1 %). In 23 patients, bleeding stopped (95.8 %) after selective embolization. One patient presented a recurrence of bleeding with hemorrhagic shock and required urgent hemorrhoidal ligature. Four patients required an emergent surgical procedure because of an ischemic event (16.7 %). One patient died of ileal ischemia (mortality, 4.1 %). The level of embolization and the length of hypoperfused colon after embolization were the only risk factors for emergent operation. Mean hospital stay was 18 days (range, 9-44 days). After a mean follow-up of 28.6 months (range, 4-108 months), no other ischemic events occurred. Conclusion In our series, selective transarterial embolization for acute colonic bleeding was clinically effective with a 21 % risk of bowel ischemia. The level of embolization and the length of the hypoperfused colon after embolization should be taken into consideration for emergent operation.

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Section: Discussionmentioning

confidence: 68%

“…In the literature, Lipof et al [13] reported 15 % of recurrences of hemorrhage (8 patients out of 71) with a mean follow-up of 32 months. Tan et al [25] reported 13 % of rebleeding at 30 days or more after the first episode (4 of 32 patients). These data finally confirm the safety of the procedure, even after long-term follow-up.…”

Section: Discussionmentioning

confidence: 99%

Transarterial embolization in acute colonic bleeding: review of 11 years of experience and long-term results

Rossetti

Buchs

Bréguet

et al. 2012

Int J Colorectal Dis

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“…Mandava et al (5) reported this rate to be 12% while Bielecki (15) reported a rate of 16.9%. Factors affecting mortality are advanced age, ASA score > 3, stoma creation, blood transfusions, technique of anastomosis, presence of colonic ischemia, advanced tumor stage and metastatic disease (16)(17)(18). In our series mortality rate was 29.4 % (n=10).…”

Section: Discussionmentioning

confidence: 54%

Management of Perforated Colon Cancers

et al. 2014

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“…The incidence of AL is a polyethyologic problem and depends on the location and conditions of its imposition. Multi-central investigations reveal that not only local changes in the bowel have an impact on AL, but also such factors as: blood transfusion, ASA score > 3, smoking, alcohol abuse, patients with diabetes mellitus, hypertonic disease, hypoproteinemia, overweight, age, sex, tumor stage, the use of steroids and neoadjuvant chemoradiotherapy, heart and lung failure and many others [7][8][9][10][11][12][13][14][15]. AL increases the risk of local recurrence and reduces overall 5-year survival [16,17].…”

Section: Introductionmentioning

confidence: 99%

The Evaluation of Risk Factors of Anastomotic Leakage in Patients With Colorectal Cancer Complicated by Ileus

Grytsenko¹,

Bedeniuk²,

Grytsenko³

et al. 2017

Int J Surg Med

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Background: Obstructive ileus and peritonitis are the most frequent complication of colorectal cancer, manifested in 8-40% cases. Anastomotic leakage (AL) is a fatal complication in colorectal surgery. In our study, we aim to analyse the safety, outcomes in patients with colon obstruction after resection with new anastomosis technique implementation and to identify prognostic value of each risk factor on the development of AL. Methods: A retrospective analysis of prospectively acquired data of 155 consecutive emergency patients with cancer of the proximal rectum and sigmoid colon complicated by chronic bowel obstruction in the stage of subcompensation and decompensation were included in our study and divided into two groups. In the basic group (n=95), primary nonfunctional anastomosis (PNA) was performed after resection of the rectum. In the comparing group (n=60), resection of the colon or rectum with primary anastomosis was performed. Results: Postoperative complications have arisen in 5(5,3%) patients of group I and 11 (18,4%) patients of group II. AL was developed only in 1 patient in the basic group (1,1%) and in 7 (11,7%) patients of the compared group on the 5 th -12 th day after the operation. We have worked out the rating score of risk factors of AL.A score was given for each AL factor which we had selected for the elaboration of this scale. Conclusions: Based on AL risk factors scale we highlighted five levels of risk which have significant clinical meaning and help surgeons decide finally how to finish operation in a patient with bowel obstruction to avoid AL. PNA with preventive transversostoma was shown to provide adequate decompression of the colon, reliable prevention of colorectal AL and avoid complex reconstructive operations.KEYWORDS: colorectal cancer, bowel obstruction, anastomotic leakage.

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Risk factors for mortality–morbidity after emergency–urgent colorectal surgery

Cited by 49 publications

References 26 publications

Transarterial embolization in acute colonic bleeding: review of 11 years of experience and long-term results

Transarterial embolization in acute colonic bleeding: review of 11 years of experience and long-term results

Management of Perforated Colon Cancers

The Evaluation of Risk Factors of Anastomotic Leakage in Patients With Colorectal Cancer Complicated by Ileus

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