Surgical outcomes and prognostic factors associated with emergency left colonic surgery

Bawa, Dauda; Khalifa, Y.; Khan, Saleem Ahmed; Norah, Waddah; Noman, Nibras

doi:10.5144/0256-4947.2023.97

Cited by 3 publications

(2 citation statements)

References 44 publications

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“…The predominance of pathologies such as obstructive colonic malignancies, diverticular disease, and volvulus in the descending and sigmoid colon is well-established in literature, and these findings have been extensively discussed. [6][7][8] Notably, our current study excluded left colon malignancies and instead focused on surgical outcomes for benign conditions.…”

Section: Discussionmentioning

confidence: 99%

Non-malignant left colon emergency surgery: evaluation of factors affecting clinical outcomes and complications

Çiftçi

2024

Ulus Travma Acil Cerrahi Derg

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BACKGROUND:Emergency colorectal resections hold a significant position in general surgical practice, and pathologies of the left colon are relatively common. This study was conducted to assess the outcomes of isolated left colon surgeries with benign etiologies, drawing on clinicopathological and biochemical data. METHODS:We carried out a retrospective review and statistical analysis of demographic, clinical, and laboratory data of patients who underwent left colon surgery at the general surgery clinic of a tertiary care hospital, excluding those with malignancy-related emergencies, from January 2017 to January 2022. RESULTS:The average age of the 48 patients in the study was 56.9±16.4 years. Complicated acute diverticulitis was the most frequent indication for emergency surgery (n=19, 39.6%). The Hartmann procedure was the surgical technique most often employed (n=30, 62.5%). The rates of postoperative morbidity and mortality within 30 days were 27.1% and 8.3%, respectively. Increased postoperative morbidity was linked to advanced age (mean 65.4±15.8 vs. 53.8±15.7, p=0.028), the preoperative administration of vasopressors, lower platelet counts, hypoalbuminemia (<3 mg/dl), and azotemia (blood urea nitrogen >20 mg/dl). There was no statistically significant correlation between comorbidities, American Society of Anesthesiologists (ASA) scores, surgical methods, or other clinical data and postoperative outcomes. CONCLUSION:For emergency colorectal surgery pertaining to left colon pathologies, it is critical to conduct a comprehensive evaluation in the perioperative period, especially for elderly and hypotensive patients with renal function abnormalities and for those requiring vasopressors.

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Section: Discussionmentioning

confidence: 99%

Non-malignant left colon emergency surgery: evaluation of factors affecting clinical outcomes and complications

Çiftçi

2024

Ulus Travma Acil Cerrahi Derg

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“…These findings are in contrast to a recent study published by Bawa et al in 0.23 (0.10–0.501) 4.29 (1.99–9.24) which the primary procedure did not influence mortality. 29 It is worthy to note that the procedure selected carries with it a vastly different complication profile. Patients in which an anastomosis was created are prone to anastomotic complications whereas creating an ostomy carries with it risks for ostomy-related complications.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with 30-day mortality and morbidity in patients undergoing emergency colorectal surgery

Alselaim,

Alsemari,

Alyabsi

et al. 2023

Ann Saudi Med

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BACKGROUND: The 30-day period following emergency colorectal surgery (ECRS) is associated with high mortality and morbidity. There is a lack of data assessing factors associated with outcomes of ECRS in the Saudi population. OBJECTIVES: Assess factors associated with 30-day postoperative mortality and complications following ECRS DESIGN: Retrospective cohort study SETTING: Single tertiary care center, Riyadh, Saudi Arabia PATIENTS AND METHODS: Demographic characteristics (age, sex, diagnosis, American Society of Anesthesiologists classification, pre-operative septic state, smoking, and comorbidities), operative characteristics (urgency, diverting ostomy, and procedure performed), and postoperative characteristics (length of stay, 30-day mortality, intensive care unit [ICU] admission, ICU length of stay, surgical site infection [SSI], readmission, reoperation, and complications) were collected from electronic medical records. Univariate logistic regression was used to evaluate association with the outcome measures (30-day mortality and postoperative complications). Multivariate logistic regression was applied to evaluate independent variables. MAIN OUTCOME MEASURE: Thirty-day postoperative mortality and morbidity SAMPLE SIZE: 241 patients RESULTS: Among 241 patients, 145 (60.2%) were men, and 80 (33.2%) patients were between 50–64 years of age. The most common indication for surgery was malignancy 138 (57%). The overall complication rate was 26.6% and the 30-day mortality rate was 11.2%. Left hemicolectomy was the most commonly performed procedure, performed in 69 (28.6%) patients. Patients between the age of 65–74 had an increased odds of death within 30 days (OR 5.25 [95% CI 1.03–26.5]) on univariate analysis. Preoperative sepsis was associated with a fourfold increase in the likelihood of 30-day mortality (OR 4.44, 95% CI 1.21–16.24, P =.024) on multivariate analysis. The likelihood of hospital re-admission increased by fivefold in patients who developed a postoperative complication (OR 5.33, 95% CI 1.30–21.78, P =.02). CONCLUSION: Preoperative sepsis was independently associated with 30-day mortality in patients undergoing ECRS, while the likelihood of hospital readmission increased in patients with postoperative complications. Expeditious control of sepsis in the emergency surgical setting by both surgical and medical interventions may reduce the likelihood of postoperative mortality. Establishing discharge protocols for postoperative ECRS patients is advocated. LIMITATIONS: Retrospective design, small sample size, and single setting

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The impact of melatonin on postoperative delirium in geriatric patients after colorectal surgery: a randomized placebo-controlled trial

ELBAKRY,

EL-DESOKY,

SAAFAN

et al. 2024

Minerva Anestesiol

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Surgical outcomes and prognostic factors associated with emergency left colonic surgery

Cited by 3 publications

References 44 publications

Non-malignant left colon emergency surgery: evaluation of factors affecting clinical outcomes and complications

Non-malignant left colon emergency surgery: evaluation of factors affecting clinical outcomes and complications

Factors associated with 30-day mortality and morbidity in patients undergoing emergency colorectal surgery

The impact of melatonin on postoperative delirium in geriatric patients after colorectal surgery: a randomized placebo-controlled trial

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