The Morbidity and Mortality of Emergent Operations for Colorectal Disease

Abstract

p6 participants in the Veterans Administration Cooperative Studies Program investigating antibiotic prophylaxis in colorectal operations, 693 consecutive patients (1978-1981) from three hospitals were studied. This report concerns 20% of these patients who presented with either perforation, obstruction, or hemorrhage necessitating emergent surgical intervention on unprepared bowel. The 30-day, in-hospital mortality of the 138 patients undergoing emergency operations was 28%. Elective colorectal procedures during the same period had a six per cent mortality rate. There is a striking difference in the cause of death in prepared patients and those needing emergent surgery. Death in prepared patients was usually of a vascular etiology, while septic-related mortality was present in only one per cent. On the other hand, despite massive doses of antibiotics, fecal diversion, surgical drainage and lavage, abdominal sepsis was documented in 20% and septic related mortality was present in 17% of patients undergoing emergency operations. Early, elective treatment and prevention of obstruction and perforation will improve our results in colorectal disease.

Surgical outcomes and prognostic factors of emergency surgery for colonic perforation: would fecal contamination increase morbidity and mortality?

“…Despite improvements in the management of septic condition with supportive care, including antibiotics, immediate surgery is still critical to achieve better outcomes. However, even after undergoing surgery, patients with colorectal perforation may encounter high rates of morbidity and mortality [1,26]. In this study, the morbidity and mortality rates were similar to those in other reports [2,12], and patients with colonic perforation still presented with poor surgical outcomes.…”

“…Colonic perforation is a life-threatening problem that presents with high morbidity and mortality of approximately >30 %, even after immediate treatment with emergency surgery [1]. This condition can occur because of various causes, and diverticulitis is the most frequent.…”

Value of Serum Procalcitonin in Evaluating the Prognosis of Sepsis in Elderly Patients with Colorectal Cancer Undergoing Emergency Colorectal Surgery

“…The most common cause of mortality in general surgical ICUs is sepsis, which may lead to MOF [15]. Earlier diagnosis and treatment to prevent sepsis in patients who undergo emergency operations for colorectal disease will improve surgical results [16]. Therefore, identifying a biomarker that can detect or rule out sepsis in the early postoperative period can help elderly patients, who may benefit from specific therapies.…”

Designing a Chimeric Vaccine Against Colorectal Cancer

“…Based on the epidemiologic studies, each year 1 million new cases are diagnosed with colorectal cancer and 500 000 patient with cancer lose their life to the disease (2). The highest incidence of colorectal cancer is reported in North America, Australia, New Zealand, Europe, and Japan and the lowest incidence is in South America, Asia, and Africa (3) .Colorectal cancer has the third highest number of patients and is the second reason cause of death due to cancer (4). Both genders have equal chance of developing colorectal cancer and the disease is mostly seen in elderly people.…”