Sex, the surgeon and physical status — Significant risk factors in elective colorectal surgery

Kingston, R. D.; Walsh, S.; Keeling, F; Robinson, Christina M.; Jescock, J

doi:10.1016/0959-8049(93)91128-8

Cited by 10 publications

(24 citation statements)

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“…A prospective examination of 618 patients undergoing elective colorectal surgery at a district general hospital during a 10-year period has recently been reported, and in an attempt to identify risk factors, a multivariant analysis was employed [3]. Operative mortality was significantly associated with poor physical status, respiratory sepsis and intra-abdominal abscess formation.…”

Section: Discussionmentioning

confidence: 99%

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: 99%

Operative mortality in colorectal surgery

Isbister

1997

Coloproctol

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“…As previously noted, in this study, 22 the obese patients were significantly more likely to be female and to have undergone a laparoscopic procedure, both of which tend be associated with lower complication rates. 117,118 The proportion of surgeries that were colorectal was not detailed, but we mention it because it is a widely cited study. 22 In their retrospective review of 153 elective colorectal procedures, Blee et al 37 found no significant difference in overall complication rates between normal weight, overweight, and obese patients.…”

Section: Overall Morbidity and Mortalitymentioning

confidence: 99%

The Impact of Obesity on Outcome after Major Colorectal Surgery

Gendall¹,

Raniga²,

Kennedy³

et al. 2007

Diseases of the Colon &Amp; Rectum

201

149

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“…29,38 However, other investigators did not report obesity as a risk factor for postoperative adverse outcomes in colorectal surgery. 36,39 Mannheim peritonitis index (MPI) was used to predict the outcome of patients with peritonitis. 25 Its simple format obviates the need for extensive laboratory workup and the sum of the points for each parameter determines the score.…”

Section: Discussionmentioning

confidence: 99%