title: Safety of bowel resection for colorectal surgical emergency in the elderly.
abstract: OBJECTIVE
  Colorectal emergency requiring radical surgery is becoming increasingly frequent in the elderly and problems remain as regards the best management policy. Our long-time experience is presented in this study.
  
  
  METHODS
  In the last 23 years, 105 elderly patients, aged > or = 65 years, with colorectal disease underwent an emergency operation in our Surgical Department. Forty-five patients (mean age 72 years) had benign disease and 60 patients (mean age 76.5 years) colorectal carcinoma.
  
  
  RESULTS
  The carcinoma was located in the left colon (68%), right colon (18%) and rectum (14%). Mostly, patients with malignant cancer presented with obstructive ileus, and patients with benign tumours with perforation and peritonitis, with a predominance of diverticulitis. A resection operation either with primary anastomosis or Hartmann's procedure was performed in 75% of cases; in the rest, only palliation was resorted to. Forty-three percent of the patients with colorectal cancer emergency were > or = 80 years of age. The mean morbidity was 25% and mortality 17%, which make up to 33% and 26.6% for benign disease, and 20% and 10% for malignant cancer, respectively. The mortality rate was higher in patients with perforation than those with obstruction.
  
  
  CONCLUSIONS
  Advanced age is not a contraindication to radical surgery in case of colorectal emergency in the elderly. In the majority, a resection operation is feasible. In high-risk patients, colostomy is a life-saving alternative.
authors.affiliation: Second Surgical Propedeutical Department, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Konstantinoupoleos 49, 54642 Thessaloniki, Greece. pavlidth@med.auth.gr
authors.forename: T E
authors.initials: TE
authors.lastname: Pavlidis
authors.forename: G
authors.initials: G
authors.lastname: Marakis
authors.forename: K
authors.initials: K
authors.lastname: Ballas
authors.forename: S
authors.initials: S
authors.lastname: Rafailidis
authors.forename: K
authors.initials: K
authors.lastname: Psarras
authors.forename: D
authors.initials: D
authors.lastname: Pissas
authors.forename: K
authors.initials: K
authors.lastname: Papanicolaou
authors.forename: A
authors.initials: A
authors.lastname: Sakantamis
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000401:mortality / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000401:mortality; D015179:Colorectal Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery*; D003107:Colorectal Surgery / Q000009:adverse effects* / Q000401:mortality; D004638:Emergency Treatment / Q000009:adverse effects*; D005260:Female; D006115:Greece; D006801:Humans; D008297:Male; D010538:Peritonitis / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D016896:Treatment Outcome