Implications of emergency operations on the colon
Identifieur interne : 001362 ( Istex/Curation ); précédent : 001361; suivant : 001363Implications of emergency operations on the colon
Auteurs : Carol E. H. Scott-Conner ; Kenneth S. ScherSource :
- The American Journal of Surgery [ 0002-9610 ] ; 1987.
Abstract
The records of 137 patients undergoing elective colonic operations and 45 patients requiring emergency large bowel operations were reviewed. The mortality rate was 37.8 percent after emergency operations compared with 5.1 percent after elective operations (p < 0.001). Patient age was not a significant prognostic variable although physiologic status of the patient had a high correlation with both morbidity and mortality.Complications followed 86.7 percent of the emergency operations and 57.7 percent of the elective operations (p < 0.001). Respiratory failure, renal and hepatic dysfunction, and cardiac events more frequently followed emergency colonic operations. Intraabdominal complications developed after 57.8 percent of the emergency operations compared with 29.9 percent of the elective operations (p < 0.005). Colonic resection and primary anastomosis in the elective setting was associated with a 7.9 percent mortality rate. A large bowel anastomosis during an emergency operation resulted in a 70 percent mortality rate (p < 0.001). When emergency colonic operation included creation of a colostomy the mortality rate was 34.4 percent. Although this mortality rate was substantial, it was significantly better than the 70 percent rate that followed attempted anastomosis under unfavorable circumstances (p < 0.02).
Url:
DOI: 10.1016/0002-9610(87)90150-4
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Carol E. H. Scott-Conner<affiliation><mods:affiliation>Huntington, West Virginia U.S.A.</mods:affiliation>
<wicri:noCountry code="subField">West Virginia U.S.A.</wicri:noCountry>
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<affiliation><mods:affiliation>Huntington, West Virginia U.S.A.</mods:affiliation>
<wicri:noCountry code="subField">West Virginia U.S.A.</wicri:noCountry>
</affiliation>
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<front><div type="abstract" xml:lang="en">The records of 137 patients undergoing elective colonic operations and 45 patients requiring emergency large bowel operations were reviewed. The mortality rate was 37.8 percent after emergency operations compared with 5.1 percent after elective operations (p < 0.001). Patient age was not a significant prognostic variable although physiologic status of the patient had a high correlation with both morbidity and mortality.Complications followed 86.7 percent of the emergency operations and 57.7 percent of the elective operations (p < 0.001). Respiratory failure, renal and hepatic dysfunction, and cardiac events more frequently followed emergency colonic operations. Intraabdominal complications developed after 57.8 percent of the emergency operations compared with 29.9 percent of the elective operations (p < 0.005). Colonic resection and primary anastomosis in the elective setting was associated with a 7.9 percent mortality rate. A large bowel anastomosis during an emergency operation resulted in a 70 percent mortality rate (p < 0.001). When emergency colonic operation included creation of a colostomy the mortality rate was 34.4 percent. Although this mortality rate was substantial, it was significantly better than the 70 percent rate that followed attempted anastomosis under unfavorable circumstances (p < 0.02).</div>
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