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Short term outcome after emergency and elective surgery for colon cancer.
Colorectal Dis. 2009 Sep; 11(7):733-9.CD

Abstract

OBJECTIVE

Emergency presentation of colon cancer is common and associated with high mortality and morbidity following surgical treatment. The purpose of this study was to evaluate postoperative mortality and complications in a consecutive and population based series.

METHOD

All patients with adenocarcinoma of the colon diagnosed between 1993 and 2007 were registered prospectively. Postoperative mortality and complication rates in elective and emergency patients were compared. Logistic regression analysis was used to identify independent risk factors for postoperative complications.

RESULTS

In the study period 1129 patients were admitted, of whom 279 (25%) presented as an emergency. A total of 999 (89%) patients underwent surgical treatment; 924 patients (82%) had a major resection. The mortality rate was 3.5% after elective and 10% after emergency operation with resection (P < 0.01), and the complication rate was 24% and 38% (P < 0.01), respectively. In patients with left-sided obstruction, the mortality rate after Hartmann's procedure was 19% compared to 3% after resection with primary anastomosis (P < 0.01). Multivariate analyses demonstrated that emergency operation, increasing age, advanced tumour stage and ASA class IV were independent risk factors for postoperative mortality.

CONCLUSION

Emergency operation for colon cancer was associated with high rates of complications and mortality, indicating that immediate surgery should be avoided if possible. Decompression of left sided obstruction with a stent seems promising, whereas no conclusion can be made with regard to optimal procedure if stent placement fails; in this study Hartmann's procedure was associated with high mortality and morbidity.

Authors+Show Affiliations

Department of Gastrointestinal Surgery, Aker University Hospital, Oslo, Norway. ole.sjo@akersykehus.noNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18624817

Citation

Sjo, O H., et al. "Short Term Outcome After Emergency and Elective Surgery for Colon Cancer." Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland, vol. 11, no. 7, 2009, pp. 733-9.
Sjo OH, Larsen S, Lunde OC, et al. Short term outcome after emergency and elective surgery for colon cancer. Colorectal Dis. 2009;11(7):733-9.
Sjo, O. H., Larsen, S., Lunde, O. C., & Nesbakken, A. (2009). Short term outcome after emergency and elective surgery for colon cancer. Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland, 11(7), 733-9. https://doi.org/10.1111/j.1463-1318.2008.01613.x
Sjo OH, et al. Short Term Outcome After Emergency and Elective Surgery for Colon Cancer. Colorectal Dis. 2009;11(7):733-9. PubMed PMID: 18624817.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Short term outcome after emergency and elective surgery for colon cancer. AU - Sjo,O H, AU - Larsen,S, AU - Lunde,O C, AU - Nesbakken,A, Y1 - 2008/07/09/ PY - 2008/7/16/pubmed PY - 2009/11/5/medline PY - 2008/7/16/entrez SP - 733 EP - 9 JF - Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland JO - Colorectal Dis VL - 11 IS - 7 N2 - OBJECTIVE: Emergency presentation of colon cancer is common and associated with high mortality and morbidity following surgical treatment. The purpose of this study was to evaluate postoperative mortality and complications in a consecutive and population based series. METHOD: All patients with adenocarcinoma of the colon diagnosed between 1993 and 2007 were registered prospectively. Postoperative mortality and complication rates in elective and emergency patients were compared. Logistic regression analysis was used to identify independent risk factors for postoperative complications. RESULTS: In the study period 1129 patients were admitted, of whom 279 (25%) presented as an emergency. A total of 999 (89%) patients underwent surgical treatment; 924 patients (82%) had a major resection. The mortality rate was 3.5% after elective and 10% after emergency operation with resection (P < 0.01), and the complication rate was 24% and 38% (P < 0.01), respectively. In patients with left-sided obstruction, the mortality rate after Hartmann's procedure was 19% compared to 3% after resection with primary anastomosis (P < 0.01). Multivariate analyses demonstrated that emergency operation, increasing age, advanced tumour stage and ASA class IV were independent risk factors for postoperative mortality. CONCLUSION: Emergency operation for colon cancer was associated with high rates of complications and mortality, indicating that immediate surgery should be avoided if possible. Decompression of left sided obstruction with a stent seems promising, whereas no conclusion can be made with regard to optimal procedure if stent placement fails; in this study Hartmann's procedure was associated with high mortality and morbidity. SN - 1463-1318 UR - https://www.unboundmedicine.com/medline/citation/18624817/Short_term_outcome_after_emergency_and_elective_surgery_for_colon_cancer_ L2 - https://doi.org/10.1111/j.1463-1318.2008.01613.x DB - PRIME DP - Unbound Medicine ER -