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Postoperative mortality and morbidity in older patients undergoing emergency right hemicolectomy for colon cancer

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Abstract

Introduction

Even with the advances in surgical technique and perioperative care, morbidity and mortality after colorectal cancer surgery remain considerable, and patients (pt) who present as an emergency have an even higher mortality and morbidity rate.

Methods

A total of 35 pt with caecum or ascending colon cancer between January 2007 and June 2015, three departments in Italy and in Poland, were included in the study. The intention of surgery in all cases was curative resection with ileo-colic anastomosis. Comparative statistical analysis was performed.

Results

Acute bowel obstruction was the major complication of CRC that led to an emergency hemicolectomy. Postoperative mortality and morbidity rates were in total 12.5 and 28.1%, respectively. All the deaths happened in Poland. Of the pt, 42.8% had morbidity in Poland and 16.6% in Italy. Out of the pt, 25% presenting with perforation: 25% died, 25% had wound dehiscence, 12.5% had pulmonary oedema, and 12.5% had an intra-abdominal abscess. The mean age of the pt with complications in Poland and in Italy was 79.3 and 72.0 years, respectively.

Conclusion

We observed that particularly lethal combination is older age, perforation with peritonitis and advanced stage of the cancer.

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Abbreviations

CRC:

Colon–rectal cancer

CT:

Computed tomography

ANOVA:

Analysis of variance

pt:

Patients

COPD:

Chronic obstructive pulmonary disease

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Acknowledgements

The authors thank the Medical University of Wrocław and the University of Perugia for the technical assistance.

Author information

Authors and Affiliations

  1. Department of Gastrointestinal and General Surgery, Medical University of Wrocław, ul. Curie-Sklodowskiej 66, 50-369, Wrocław, Poland

    Renata Tabola & George Mantese

  2. Department of General and Oncological Surgery, University of Perugia, Località Sant’Andrea delle Fratte 1, 06134, Perugia, Italy

    Roberto Cirocchi, Alessandro Gemini, Veronica Grassi & Carlo Boselli

  3. Department of General Surgery, Terni Saint Mary Hospital, University of Perugia, Via Tristano di Joannuccio 1, 05100, Terni, Italy

    Stefano Avenia, Alessandro Sanguinetti & Nicola Avenia

  4. Department of Minimally Invasive Surgery and Proctology, Medical University of Wroclaw, ul. Borowska 213, 50-556, Wrocław, Poland

    Maciej Sroczynski & Jaroslaw Wierzbicki

Authors
  1. Renata Tabola
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  2. George Mantese
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  3. Roberto Cirocchi
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  4. Alessandro Gemini
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  5. Veronica Grassi
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  6. Carlo Boselli
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Corresponding author

Correspondence to Roberto Cirocchi.

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Conflict of interest

All authors listed have contributed sufficiently to the project to be included as authors, and to the best of our knowledge, no conflict of interest, financial or other exists.

Funding

The authors declare that they have received no funding for the study.

Human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent to the radiological procedure and to the processing of own personal data was obtained from each individual study participant. In accordance with Italian Drug Agency (AIFA) guidelines, observational studies using retrospective data or materials do not require formal approval by the local ethics committee.

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Tabola, R., Mantese, G., Cirocchi, R. et al. Postoperative mortality and morbidity in older patients undergoing emergency right hemicolectomy for colon cancer. Aging Clin Exp Res 29 (Suppl 1), 121–126 (2017). https://doi.org/10.1007/s40520-016-0643-1

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  • DOI: https://doi.org/10.1007/s40520-016-0643-1

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