Skip to main content
NCBI home page
Annals of Surgery logoLink to Annals of Surgery
. 1984 May;199(5):598–603. doi: 10.1097/00000658-198405000-00015

The morbidity and mortality of emergent operations for colorectal disease.

G L Irvin 3rd, J S Horsley 3rd, J A Caruana Jr
PMCID: PMC1353500  PMID: 6609686

Abstract

p6 participants in the Veterans Administration Cooperative Studies Program investigating antibiotic prophylaxis in colorectal operations, 693 consecutive patients (1978-1981) from three hospitals were studied. This report concerns 20% of these patients who presented with either perforation, obstruction, or hemorrhage necessitating emergent surgical intervention on unprepared bowel. The 30-day, in-hospital mortality of the 138 patients undergoing emergency operations was 28%. Elective colorectal procedures during the same period had a six per cent mortality rate. There is a striking difference in the cause of death in prepared patients and those needing emergent surgery. Death in prepared patients was usually of a vascular etiology, while septic-related mortality was present in only one per cent. On the other hand, despite massive doses of antibiotics, fecal diversion, surgical drainage and lavage, abdominal sepsis was documented in 20% and septic related mortality was present in 17% of patients undergoing emergency operations. Early, elective treatment and prevention of obstruction and perforation will improve our results in colorectal disease.

Full text

PDF
598

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Albrechtsen D., Bergan A., Nygaard K., Gjone E., Flatmark A. Urgent surgery for ulcerative colitis: early colectomy in 132 patients. World J Surg. 1981 Jul;5(4):607–615. doi: 10.1007/BF01655016. [DOI] [PubMed] [Google Scholar]
  2. Block G. E., Moossa A. R., Simonowitz D., Hassan S. Z. Emergency colectomy for inflammatory bowel disease. Surgery. 1977 Oct;82(4):531–536. [PubMed] [Google Scholar]
  3. Boyd J. B., Bradford B., Jr, Watne A. L. Operative risk factors of colon resection in the elderly. Ann Surg. 1980 Dec;192(6):743–746. doi: 10.1097/00000658-198012000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Clarke J. S., Condon R. E., Bartlett J. G., Gorbach S. L., Nichols R. L., Ochi S. Preoperative oral antibiotics reduce septic complications of colon operations: results of prospective, randomized, double-blind clinical study. Ann Surg. 1977 Sep;186(3):251–259. doi: 10.1097/00000658-197709000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Condon R. E., Bartlett J. G., Greenlee H., Schulte W. J., Ochi S., Abbe R., Caruana J. A., Gordon H. E., Horsley J. S., Irvin G., 3rd Efficacy of oral and systemic antibiotic prophylaxis in colorectal operations. Arch Surg. 1983 Apr;118(4):496–502. doi: 10.1001/archsurg.1983.01390040100021. [DOI] [PubMed] [Google Scholar]
  6. Dutton J. W., Hreno A., Hampson L. G. Mortality and prognosis of obstructing carcinoma of the large bowel. Am J Surg. 1976 Jan;131(1):36–41. doi: 10.1016/0002-9610(76)90417-7. [DOI] [PubMed] [Google Scholar]
  7. Greif J. M., Fried G., McSherry C. K. Surgical treatment of perforated diverticulitis of the sigmoid colon. Dis Colon Rectum. 1980 Oct;23(7):483–487. doi: 10.1007/BF02987083. [DOI] [PubMed] [Google Scholar]
  8. Howe H. J., Casali R. E., Westbrook K. C., Thompson B. W., Read R. C. Acute perforations of the sigmoid colon secondary to diverticulitis. Am J Surg. 1979 Feb;137(2):184–187. doi: 10.1016/0002-9610(79)90141-7. [DOI] [PubMed] [Google Scholar]
  9. Raftery T. L., Samson N. Carcinoma of the colon: a clinical correlation between presenting symptoms and survival. Am Surg. 1980 Nov;46(11):600–606. [PubMed] [Google Scholar]
  10. ReMine S. G., Dozois R. R. Hartmann's procedure. Its use with complicated carcinomas of sigmoid colon and rectum. Arch Surg. 1981 May;116(5):630–633. doi: 10.1001/archsurg.1981.01380170110020. [DOI] [PubMed] [Google Scholar]
  11. Stothert J. C., Jr, Brubacher L., Simonowitz D. A. Complications of emergency stoma formation. Arch Surg. 1982 Mar;117(3):307–309. doi: 10.1001/archsurg.1982.01380270033007. [DOI] [PubMed] [Google Scholar]
  12. Terry B. G., Beart R. W., Jr Emergency abdominal colectomy with primary anastomosis. Dis Colon Rectum. 1981 Jan-Feb;24(1):1–4. doi: 10.1007/BF02603439. [DOI] [PubMed] [Google Scholar]
  13. Wara P., Sørensen K., Berg V. Proximal fecal diversion: review of ten years' experience. Dis Colon Rectum. 1981 Mar-Apr;24(2):114–119. doi: 10.1007/BF02604299. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES