Colorectal surgery in cirrhotic patients: Assessment of operative morbidity and mortality

被引:62
作者
Meunier, K. [1 ]
Mucci, S. [1 ]
Quentin, V. [2 ]
Azoulay, R. [1 ]
Arnaud, J. P. [1 ]
Hamy, A. [1 ]
机构
[1] Univ Hosp Angers, Dept Gen Surg, F-49933 Angers, France
[2] Univ Hosp Angers, Dept Gastroenterol, F-49933 Angers, France
关键词
cirrhosis; colorectal surgery; morbidity; mortality;
D O I
10.1007/s10350-008-9336-y
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
PURPOSE: The morbidity from colorectal surgery can be high and increases for patients with cirrhosis of the liver. This study was designed to assess morbidity, mortality, and prognostic factors for patients with cirrhosis undergoing colorectal surgery. METHODS: From 1993 to 2006, 41 cirrhotic patients underwent 43 colorectal procedures and were included. Both univariate and multivariate analyses were performed to identify variables influencing morbidity and mortality. RESULTS: Postoperative morbidity was 77 percent (33/43). Postoperative mortality was 26 percent (11/43) among whom six patients (54 percent) underwent emergency surgery. Four factors influenced mortality on univariate analysis: presence of peritonitis (P < 0.05), postoperative complications (P < 0.04), postoperative infections (P < 0.01), and total colectomy procedures (P < 0.02). On multivariate analysis, the only factor influencing mortality was postoperative infection (P < 0.04). The only factor influencing morbidity was the existence of preoperative ascites (P < 0.04). CONCLUSIONS: Colorectal surgery for cirrhotic patients has a high risk of morbidity and mortality. This risk is associated with the presence of infection, ascitic decompensation, and the urgent or extensive nature of the procedure. The optimization of patients through selection and preparation reduces operative risk.
引用
收藏
页码:1225 / 1231
页数:7
相关论文
共 50 条
[32]   Ulcerative colitis: Operative morbidity and mortality in 100 cases [J].
Aouad, A ;
ElHijri, A ;
Azzouzi, A ;
Kanjaa, N ;
ElAlaoui, M ;
Benradi, H ;
Slaoui, A .
JOURNAL DE CHIRURGIE, 1996, 133 (07) :307-310
[33]   Perioperative determinants of morbidity and mortality in elderly patients undergoing cardiac surgery [J].
Rady, MY ;
Ryan, T ;
Starr, NJ .
CRITICAL CARE MEDICINE, 1998, 26 (02) :225-235
[34]   Factors affecting mortality and morbidity in emergency abdominal surgery in geriatric patients [J].
Ozkan, Erkan ;
Fersahoglu, Mehmet Mahir ;
Dulundu, Ender ;
Ozel, Yahya ;
Yildiz, Mehmet Kamil ;
Topaloglu, Umit .
ULUSAL TRAVMA VE ACIL CERRAHI DERGISI-TURKISH JOURNAL OF TRAUMA & EMERGENCY SURGERY, 2010, 16 (05) :439-444
[35]   Effect of Neoadjuvant Chemoradiation on Operative Mortality and Morbidity for Pancreaticoduodenectomy [J].
Tsung-Yen Cheng ;
Ketan Sheth ;
Rebekah R. White ;
Tomio Ueno ;
Cheng-Fang Hung ;
Bryan M. Clary ;
Theodore N. Pappas ;
Douglas S. Tyler .
Annals of Surgical Oncology, 2006, 13 :66-74
[36]   Effect of neoadjuvant chemoradiation on operative mortality and morbidity for pancreaticoduodenectomy [J].
Cheng, TY ;
Sheth, K ;
White, RR ;
Ueno, T ;
Hung, CF ;
Clary, BM ;
Pappas, TN ;
Tyler, DS .
ANNALS OF SURGICAL ONCOLOGY, 2006, 13 (01) :66-74
[37]   Association of Pre-Operative Hyponatraemia with Morbidity and Mortality in Patients Undergoing Non-Urgent Degenerative Spine Surgery, a Retrospective Study [J].
Algarni, Nizar ;
Marwan, Yousef ;
Bokhari, Rakan ;
Nooh, Anas ;
Addar, Abdullah ;
Alshammari, Abdullah ;
Alageel, Musab ;
Weber, Michael H. .
HEALTHCARE, 2024, 12 (11)
[38]   Risk factors for mortality–morbidity after emergency–urgent colorectal surgery [J].
K. Skala ;
P. Gervaz ;
N. Buchs ;
I. Inan ;
M. Secic ;
B. Mugnier-Konrad ;
P. Morel .
International Journal of Colorectal Disease, 2009, 24 :311-316
[39]   Preoperative incremental shuttle walk test for morbidity and mortality prediction in elective major colorectal surgery [J].
Soumya, C. N. ;
Thomas, Mary ;
Ravindran, Subha ;
Krishna, Jagathnath K. M. .
INDIAN JOURNAL OF ANAESTHESIA, 2022, 66 :250-256
[40]   FACTORS IMPACTING MORTALITY IN TURKISH OCTOGENARIAN AND NONAGENARIAN PATIENTS WHO UNDERWENT COLORECTAL SURGERY [J].
Ceylan, Cengiz ;
Ocakli, Serhat ;
Akinci, Felat ;
Cetinkaya, Erdinc ;
Agackiran, Ibrahim ;
Akin, Tezcan ;
Er, Sadettin .
JOURNAL OF MEDICAL AND SURGICAL RESEARCH, 2022, 9 (02)