Is emergency right hemicolectomy still associated with significant morbidity and mortality rates? An institution’s experience of 207 cases over 6 years

Tan, Ker‐Kan; Liu, Jody Zhiyang; Yeow, Yuyi; Gunasekaran, S.; Tan, Jane Jye-Yng

doi:10.1007/s00384-011-1203-y

Cited by 14 publications

(11 citation statements)

References 17 publications

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“…Kobayashi class III in a cohort of 15,275 patients who underwent emergency or elective right hemicolectomy [5]. In addition, multiple other studies, both retrospective and prospective, associated ASA class III or higher with increased risks of mortality and/or major morbidity [3,11,19,20,33]. Advanced age and ASA class III or higher are therefore likely to be independent risk factors for mortality, and those patients may have most benefit from other treatment alternatives.…”

Section: Discussionmentioning

confidence: 97%

Emergency resection versus bridge to surgery with stenting in patients with acute right-sided colonic obstruction: a systematic review focusing on mortality and morbidity rates

Amelung

Beaufort

Siersema

et al. 2015

Int J Colorectal Dis

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Primary resection for patients with acute RSCO seems to be associated with higher mortality and major morbidity rates than stent placement and elective resection. In addition, stent placement resulted in fewer anastomotic leakages and permanent ileostomies. However, as no high-level studies are available on the optimal treatment of RSCO and proximal stenting is considered technically challenging, future comparative studies are warranted for the development of an evidence-based clinical decision guideline.

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Section: Discussionmentioning

confidence: 97%

Emergency resection versus bridge to surgery with stenting in patients with acute right-sided colonic obstruction: a systematic review focusing on mortality and morbidity rates

Amelung

Beaufort

Siersema

et al. 2015

Int J Colorectal Dis

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“…Another question that begs answering is what operation to perform when faced with an unexpected inflamed non‐perforated colon. While some may argue that right colectomy can be definitive in curing the pathology, its potential complications are considerable . Appendectomy without colonic resection has also been advocated by some to negate the risk of developing appendicitis in the future as there may be a similar underlying aetiology that precipitated both entities .…”

Section: Discussionmentioning

confidence: 99%

“…While some may argue that right colectomy can be definitive in curing the pathology, its potential complications are considerable. 18 Appendectomy without colonic resection has also been advocated by some to negate the risk of developing appendicitis in the future as there may be a similar underlying aetiology that precipitated both entities. 12 The necessity and implications of a stoma following colonic resection when faced with a perforated left-sided pathology have already drawn its fair share of dispute and may be extrapolated to right-sided patholgy.…”

Section: Discussionmentioning

confidence: 99%

Colonic diverticulitis in young Asians: a predominantly mild and right‐sided disease

Tan

Wong

Yan

et al. 2013

ANZ Journal of Surgery

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Background: The management of diverticulitis in young Asian patients remains challenging. This study aimed to highlight the issues of managing diverticulitis in young Asians. Methods: A retrospective review of all patients who were admitted for acute colonic diverticulitis from October 2003 to December 2008 was performed. Patients who were ≤50 year old were considered 'young' and formed the study group. Results: The study group consisted of 142 patients. The majority (n = 126, 88.7%) had right-sided diverticulitis and most (n = 117, 82.4%) were mild in severity. Most of the patients who underwent emergency surgery were for suspected appendicitis (39/ 56, 69.6%). When we compared between those aged ≤50 and >50 years, the older group had worse diverticulitis (odds ratio (OR), 4.90, 95% confidence interval (CI), 2.00-11.99), been operated for indications other than suspected appendicitis (OR, 13.08, 95% CI, 5.42-31.56) and undergone a colectomy (OR, 9.96, 95% CI, 4.12-24.10). The younger group had a much higher incidence of right-sided disease (OR: 7.80, 95% CI: 4.32-14.07). Over a median follow-up of 40 (6-90) months, 7 (4.9%) patients were readmitted for a total of eight times for recurrent attacks of diverticulitis and all were successfully treated conservatively. Five other patients underwent elective surgery for persistent symptoms. Conclusion: Diverticulitis in young Asians is often right-sided and mild in severity. A significant proportion is only diagnosed when operated for presumed appendicitis. Recurrent attacks are uncommon and can often be treated non-surgically.

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“…In addition, emergency right colectomies have the disadvantage of having a higher risk of stoma, morbidity and mortality, especially in the case of patients with higher American Society of Anesthesiologists scores, as suggested by Tan et al [ 160 ]. In a retrospective analysis, of 207 patients undergoing emergency right colectomy for various indications, 39 patients (18.8%) had severe complications and 20 were deceased (9.7%).…”

Section: Discussionmentioning

confidence: 99%

Caecal diverticulitis can be misdiagnosed as acute appendicitis: a systematic review of the literature

Uhe¹,

Meyer

Viviano

et al. 2021

Colorectal Disease

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Aim Caecal diverticulitis (CD) is an uncommon condition which can be misdiagnosed as acute appendicitis due to similar clinical presentations. Further, its management varies among medical centres. The aim of this study was to review cases of patients with CD, to identify the factors differentiating CD from acute appendicitis and to provide a summary of existing diagnostic methods and therapeutic alternatives regarding its management. Methods This systematic review was conducted in accordance with the PRISMA guidelines and the AMSTAR2 checklist. We searched MEDLINE and Embase from inception until 1 October 2018 for original publications reporting cases of CD. Results Out of the 560 identified studies, 146 publications (988 patients) were included in the qualitative synthesis. Most frequent symptoms of CD were right iliac fossa pain (93.2%), nausea and/or vomiting (35.4%) and fever (26.9%). A total of 443 patients (44.8%) underwent radiological imaging, which reported CD in 225 patients (22.8%). For the other patients, the diagnosis was obtained by surgical exploration (73.9%). Among patients diagnosed with CD by imaging, 67 (29.8%) underwent surgery and 158 (70.2%) were treated conservatively. Among patients who underwent surgical exploration, treatment consisted most frequently of right hemi‐colectomy (33%), appendectomy (18.8%) and diverticulectomy with appendectomy (16.3%). Conclusion CD can be misdiagnosed as acute appendicitis, therefore resulting in unnecessary surgical exploration. The review of the literature starting from 1930 highlights the critical role of medical imaging in supporting the clinician to diagnose this condition and administer adequate treatment.

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Is emergency right hemicolectomy still associated with significant morbidity and mortality rates? An institution’s experience of 207 cases over 6 years

Abstract: Emergency right hemicolectomy is associated with a significant morbidity and mortality rate. Patients with higher ASA score and who had stoma created fared worse.

Cited by 14 publications

References 17 publications

Emergency resection versus bridge to surgery with stenting in patients with acute right-sided colonic obstruction: a systematic review focusing on mortality and morbidity rates

Emergency resection versus bridge to surgery with stenting in patients with acute right-sided colonic obstruction: a systematic review focusing on mortality and morbidity rates

Colonic diverticulitis in young Asians: a predominantly mild and right‐sided disease

Caecal diverticulitis can be misdiagnosed as acute appendicitis: a systematic review of the literature

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