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


CONCLUSIONS
We observed that particularly lethal combination is older age, perforation with peritonitis and advanced stage of the cancer.
Department of Gastrointestinal and General Surgery, Medical University of Wrocław, ul. Curie-Sklodowskiej 66, 50-369, Wrocław, Poland.
Renata
R
Tabola
Department of Gastrointestinal and General Surgery, Medical University of Wrocław, ul. Curie-Sklodowskiej 66, 50-369, Wrocław, Poland.
George
G
Mantese
Department of General and Oncological Surgery, University of Perugia, Località Sant'Andrea delle Fratte 1, 06134, Perugia, Italy. roberto.cirocchi@unipg.it.
Roberto
R
Cirocchi
Department of General and Oncological Surgery, University of Perugia, Località Sant'Andrea delle Fratte 1, 06134, Perugia, Italy.
Alessandro
A
Gemini
Department of General and Oncological Surgery, University of Perugia, Località Sant'Andrea delle Fratte 1, 06134, Perugia, Italy.
Veronica
V
Grassi
Department of General and Oncological Surgery, University of Perugia, Località Sant'Andrea delle Fratte 1, 06134, Perugia, Italy.
Carlo
C
Boselli
Department of General Surgery, Terni Saint Mary Hospital, University of Perugia, Via Tristano di Joannuccio 1, 05100, Terni, Italy.
Stefano
S
Avenia
Department of General Surgery, Terni Saint Mary Hospital, University of Perugia, Via Tristano di Joannuccio 1, 05100, Terni, Italy.
Alessandro
A
Sanguinetti
Department of General Surgery, Terni Saint Mary Hospital, University of Perugia, Via Tristano di Joannuccio 1, 05100, Terni, Italy.
Nicola
N
Avenia
Department of Minimally Invasive Surgery and Proctology, Medical University of Wroclaw, ul. Borowska 213, 50-556, Wrocław, Poland.
Maciej
M
Sroczynski
Department of Minimally Invasive Surgery and Proctology, Medical University of Wroclaw, ul. Borowska 213, 50-556, Wrocław, Poland.
Jaroslaw
J
Wierzbicki
D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery; D004638:Emergency Treatment / Q000379:methods / Q000401:mortality; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology; D007558:Italy; D008297:Male; D009026:Mortality; D010043:Outcome and Process Assessment, Health Care; D011044:Poland; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors
Emergency; Older; Right hemicolectomy; Surgery