Outcome analysis of patients undergoing colorectal resection for emergent and elective indications

• Published in: The American surgeon Vol. 73; no. 10; pp. 991 - 993
• Main Authors: KIM, Justin, MITTAL, Raj, KONYALIAN, Viken, KING, Justin, STAMOS, Michael J, KUMAR, Ravin R
• Format: Conference Proceeding Journal Article
• Language: English
• Published: Atlanta, GA Southeastern Surgical Congress 01.10.2007; SAGE PUBLICATIONS, INC
• Subjects: Abdominal Abscess - surgery; Biological and medical sciences; Biomedical research; Colectomy; Colon - injuries; Colonic Neoplasms - surgery; Diverticulitis, Colonic - surgery; Elective Surgical Procedures; Emergency Treatment; Female; General aspects; Humans; Male; Medical sciences; Middle Aged; Mortality; Retrospective Studies; Risk factors; Studies; Surgery; Surgical Wound Dehiscence - epidemiology; Surgical Wound Infection - epidemiology; Teaching hospitals; Treatment Outcome; Human; Medicine; Prognosis; Treatment; Indication; Surgery; Rectum; Evolution; Patient; Surgical resection; Colon
• ISSN: 0003-1348; 1555-9823
• DOI: 10.1177/000313480707301014

Despite advances in perioperative care and operative techniques, urgent colorectal operations are associated with higher morbidity and mortality. To evaluate our rate of complications in elective and urgent colorectal operations, we performed retrospective chart review of 209 consecutive patients who underwent colorectal resection between 1998 and 2002 at Harbor-UCLA Medical Center. One hundred, forty-three (71%) patients underwent elective colorectal resection. A total of 19 (13.3%) complications occurred in the elective group, compared with 24 (38.1%) in the urgent group (P = 0.003). Both right-sided and left-sided operations were associated with higher incidence of complications when performed urgently. Wound infection occurred in 7.7 per cent of patients undergoing an elective operation and 14.3 per cent in an urgent setting (P = 0.21). Intra-abdominal abscess occurred in 1.4 per cent of patients undergoing elective operation, compared with 11.1 per cent in the urgent operation group. Four (1.9%) patients developed wound dehiscence, 1 in elective and 3 in the urgent group (P = 0.09). Anastomotic leak occurred in 1.9 per cent of patients, 2 in each group (P = 0.6). There were six deaths, 3 in elective and 3 in urgent cases (P = 0.4). Urgent operation of the colon and rectum is associated with higher incidence of complications. Both right- and left-sided resections have a higher complication rate when performed in a nonelective setting.