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PERIOPERATIVE MORBIDITY AND MORTALITY AFTER EMERGENCY AND ELECTIVE COLON AND PROXIMAL RECTAL SURGERY IN IBADAN
O O Ayandipo1,2, O O Afuwape1,2, A B Ojo2
1Department of Surgery, College of Medicine, University of Ibadan, Nigeria.
Annals of Ibadan Postgraduate Medicine
|February 24, 2021
Summary
Colorectal cancer surgery outcomes reveal high morbidity and mortality, especially in emergency cases with bowel obstruction. Perforation and gangrene significantly increase surgical risks, highlighting the need for timely intervention in colorectal cancer patients.
Area of Science:
- Colorectal surgery
- Surgical oncology
- Gastrointestinal disease epidemiology
Background:
- Colorectal cancer incidence is rising, with many patients presenting with advanced disease and large bowel obstruction.
- Benign colonic pathologies show stable epidemiology, contrasting with increasing colorectal cancer rates.
Purpose of the Study:
- To review perioperative morbidity and mortality for emergency and elective colon and proximal rectal surgeries.
- To identify risk factors associated with adverse outcomes in colorectal surgery.
Main Methods:
- A prospective study of 1618 patients undergoing surgery for lower gastrointestinal tract symptoms (caecum to proximal rectum) between 2008 and 2018.
- Data collected included presentation type (emergency/elective), operative details, and postoperative course.
Main Results:
- 817 patients (50.5%) underwent surgery, with 38.1% emergency and 61.9% elective presentations.
- Overall morbidity was 13.7% (emergency 9.5%, elective 4.2%) and mortality was 6.8% (emergency 4.7%, elective 2.1%).
- Superficial surgical site infection and wound dehiscence were common morbidities; bowel perforation or gangrene predicted mortality.
Conclusions:
- Large bowel obstruction with perforation and gangrene is a significant risk factor for morbidity and mortality in colorectal surgery.
- Emergency presentations and advanced disease stages contribute to poorer surgical outcomes.
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