title: [Clinical differences between surgically treated patients with large bowel obstruction in the cities of Van and Istanbul].
abstract: OBJECTIVE
  Geographical differences between cases of colonic obstructions affect clinical course and outcome of patients. We aimed to establish regional clinical differences between patients with colonic obstruction from eastern and western regions of Turkey.
  
  
  METHODS
  We retrospectively analysed 224 patients with colonic obstruction who were surgically treated in two hospital situated in Istanbul from western and in Van from eastern regions of Turkey. This analysis was made in respect of demographic features, causes of obstruction and location in the colon, complicated obstructions, postoperative clinical course and mortality.
  
  
  RESULTS
  Men constituted 71.4% of patients with a mean age of 55.5 years. Obstruction site was the left colon in 82.5% and the sigmoid in 66% of patients from western region, and 91.7% (p = 0.03), and 85% (p = 0.007) respectively of those from eastern region. The leading causes of obstruction were obstructive cancer (52.5%) in Istanbul and volvulus (80.2%) Van respectively (p < 0.001). The colonic obstruction was complicated in 22% of patients. The rate of complicated obstruction was 17.5% and 26.4% (p = 0.07) in Van respectively. The overall postoperative mortality was found as 12.9%. The mortality being 8.6% in simple obstruction raised to 28% (p = 0.008) in complicated patients.
  
  
  CONCLUSIONS
  We found significant differences in colonic obstruction cases between eastern and western parts of Turkey. The incidence of complicated obstruction is bigger in eastern region. A considerable mortality arises in surgically treated patients with colonic obstruction. Postoperative mortality was significantly elevated in cases of obstruction complicated by strangulation, necrosis, and perforation.
authors.affiliation: Haydarpaşa Numune Eğitim ve Araştirma Hastanesi 4. Genel Cerrahi Kliniği, Istanbul.
authors.forename: Günay
authors.initials: G
authors.lastname: Gürleyik
authors.forename: Cetin
authors.initials: C
authors.lastname: Kotan
authors.forename: Ender
authors.initials: E
authors.lastname: Dulundu
authors.forename: Erol
authors.initials: E
authors.lastname: Oztürk
authors.forename: Reşit
authors.initials: R
authors.lastname: Sönmez
authors.forename: Abdullah
authors.initials: A
authors.lastname: Sağlam
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003110:Colonic Neoplasms / Q000453:epidemiology / Q000601:surgery; D003112:Colonic Pseudo-Obstruction / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000592:standards; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000453:epidemiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D012189:Retrospective Studies; D012737:Sex Factors; D016019:Survival Analysis; D014421:Turkey / Q000453:epidemiology