The Outcome of Colorectal Surgery in Cirrhotic Patients: A Case Match Report

Background: Colorectal surgery in cirrhotic patients has had limited indications, but as the study aims to show, careful evaluation of risk factors can extend boundaries. Methods: From January 2011 to January 2016, using a case match cohort, 68 patients with colorectal malignancy and cirrhosis were compared against 136 persons with no liver disease. Significant risk criteria, morbidity and mortality were evaluated. Results: When analyzing specific risk factors age, etiology and severity of liver disease (MELD, Child-Pugh score, ascites and hypoalbuminemia) were found to be significant to surgical outcome. Approach and type of intervention as well as emergency status reflected upon reintervention rates with 10.2% in the cirrhotic population vs 5.1% in the non-cirrhotic one (p=0.3). Postoperative morbidity was higher in the chronic liver disease patients - 47.1% vs 27.9% in the case-match group (p=0.035). Mortality rate in the cirrhotic population was 5.9% while in the non-cirrhotic one was 2.2% (p=0.2). Child C patients had a morbidity and a mortality rate of 75% and 50% respectively.

Child A patients can be treated no different than the general population; Child B group needs proper assessment and care while in Child C population surgery should at all costs be avoided.