Non-malignant left colon emergency surgery: evaluation of factors affecting clinical outcomes and complications

BACKGROUND: Emergency colorectal resections hold a significant position in general surgical practice, and pathologies of the left colon are relatively common. This study was conducted to assess the outcomes of isolated left colon surgeries with benign etiologies, drawing on clinicopathological and biochemical data.
METHODS: We carried out a retrospective review and statistical analysis of demographic, clinical, and laboratory data of patients who underwent left colon surgery at the general surgery clinic of a tertiary care hospital, excluding those with malignancy-related emergencies, from January 2017 to January 2022.
RESULTS: The average age of the 48 patients in the study was 56.9±16.4 years. Complicated acute diverticulitis was the most frequent indication for emergency surgery (n=19, 39.6%). The Hartmann procedure was the surgical technique most often employed (n=30, 62.5%). The rates of postoperative morbidity and mortality within 30 days were 27.1% and 8.3%, respectively. Increased postoperative morbidity was linked to advanced age (mean 65.4±15.8 vs. 53.8±15.7, p=0.028), the preoperative administration of vasopressors, lower platelet counts, hypoalbuminemia (<3 mg/dl), and azotemia (blood urea nitrogen >20 mg/dl). There was no statistically significant correlation between comorbidities, American Society of Anesthesiologists (ASA) scores, surgical methods, or other clinical data and postoperative outcomes.
CONCLUSION: For emergency colorectal surgery pertaining to left colon pathologies, it is critical to conduct a comprehensive evaluation in the perioperative period, especially for elderly and hypotensive patients with renal function abnormalities and for those requiring vasopressors.

Non-malign acil sol kolon cerrahisi: klinik sonuçlar ve komplikasyonlar üzerine etkili faktörlerin deðerlendirilmesi

AMAÇ: Acil kolorektal rezeksiyonlar genel cerrahi pratiðinde önemli yer tutmakta ve sol kolon yerleþimli patolojiler azýmsanmayacak ölçüde görülmektedir. Çalýþmamýzda, benign etiyolojili izole sol kolon cerrahisi sonuçlarýný klinikopatolojik ve biyokimyasal veriler üzerinden deðerlendirmeyi amaçladýk.
GEREÇ VE YÖNTEM: Üçüncü basamak bir hastane genel cerrahi kliniðinde, Ocak 2017-Ocak 2022 tarihleri arasýnda malignite acilleri haricinde sol kolon cerrahisi yapýlan hastalarýn, demografik, klinik ve laboratuvar verileri retrospektif olarak taranarak istatistiksel analizi yapýldý.
BULGULAR: Çalýþmaya dahil edilen 48 hastanýn yaþ ortalamasý 56.9±16.4 yýl idi. En sýk acil cerrahi endikasyonu komplike akut divertikülit idi (n=19, %39.6). En sýk yapýlan cerrahi teknik hartmann prosedürüydü (n=30, %62.5). Postoperatif morbidite ve mortalite (30 gün içinde) oranýmýz sýrasýyla %27.1 ve %8.3 idi. Ýleri yaþ (ortalama 65.4±15.8’e karþýn 53.8±15.7, p=0.028), preoperatif vazopressör ajan kullanýmý, daha düþük trombosit düzeyleri, hipoalbuminemi (<3 mg/dl) ve azotemi (üre>20 mg/dl) artmýþ postoperarif morbiditeyle iliþkiliydi. Komorbidite, American Society of Anesthesiologists (ASA) skoru, cerrahi teknik ve diðer klinik veriler ile postoperatif sonuçlar arasýnda istatistiksel anlamlýlýk bulunamadý.
SONUÇ: Sol kolon patolojileri nedeniyle yapýlan acil kolorektal cerrahide; yaþlý, böbrek fonksiyon anormalliði olan ve vazopressör kullanýmý gerektiren hipotansif hastalarýn perioperatif süreçte kapsamlý deðerlendirilmeleri gerekmektedir.