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JYMS : Journal of Yeungnam Medical Science

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Do-bin Lee 1 Article
Patient outcomes and prognostic factors associated with colonic perforation surgery: a retrospective study
Do-bin Lee, Seonhui Shin, Chun-Seok Yang
J Yeungnam Med Sci. 2022;39(2):133-140.   Published online October 29, 2021
DOI: https://doi.org/10.12701/yujm.2021.01445
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  • 1 Web of Science
  • 3 Crossref
AbstractAbstract PDF
Background
Despite advances in surgery and intensive perioperative care, fecal peritonitis secondary to colonic perforation is associated with high rates of morbidity and mortality. This study was performed to review the outcomes of patients who underwent colonic perforation surgery and to evaluate the prognostic factors associated with mortality.
Methods
A retrospective analysis was performed on 224 consecutive patients who underwent emergency colonic perforation surgery between January 2008 and May 2019. We divided the patients into survivor and non-survivor groups and compared their surgical outcomes.
Results
The most common cause of colon perforation was malignancy in 54 patients (24.1%), followed by iatrogenic perforation in 41 (18.3%), stercoral perforation in 39 (17.4%), and diverticulitis in 37 (16.5%). The sigmoid colon (n=124, 55.4%) was the most common location of perforation, followed by the ascending colon, rectum, and cecum. Forty-five patients (20.1%) died within 1 month after surgery. Comparing the 179 survivors with the 45 non-survivors, the patient characteristics associated with mortality were advanced age, low systolic blood pressure, tachycardia, organ failure, high C-reactive protein, high creatinine, prolonged prothrombin time, and high lactate level. The presence of free or feculent fluid, diffuse peritonitis, and right-sided perforation were associated with mortality. In multivariate analysis, advanced age, organ failure, right-sided perforation, and diffuse peritonitis independently predicted mortality within 1 month after surgery.
Conclusion
Age and organ failure were prognostic factors for mortality associated with colon perforation. Furthermore, right-sided perforation and diffuse peritonitis demonstrated a significant association with patient mortality.

Citations

Citations to this article as recorded by  
  • Colorectal Oncologic Emergencies
    Joshua Sullivan, Alec Donohue, Shaun Brown
    Surgical Clinics of North America.2024; 104(3): 631.     CrossRef
  • One Year of Experience Managing Peritonitis Secondary to Gastrointestinal Perforation at a Tertiary Care Hospital: A Retrospective Analysis
    Muhammad Hasaan Shahid, Faisal I Khan, Zain Askri, Arslan Asad, M. Azhar Alam, Danish Ali, Rabia Saeed, Aun Jamal, Tauseef Fatima, M. Farooq Afzal
    Cureus.2022;[Epub]     CrossRef
  • Risk factors for urgent complications of colorectal cancer
    S. N. Shchaeva
    Pelvic Surgery and Oncology.2022; 12(2): 28.     CrossRef

JYMS : Journal of Yeungnam Medical Science