Kolorektal Kanserin Acil Rezeksiyonlar�nda Morbidite ve Mortalite ile �li�kili Risk Fakt�rleri

Kesgin, Yasir Musa; Donmez, Turgut; Surek, Ahmet; Canoz, Ozden; Gumusoglu, Alpen Yahya; Guzey, Deniz; Karabulut, Mehmet

Cilt : 31 Say� : 12 Y�l : 2025

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Kolorektal Kanserin Acil Rezeksiyonlar�nda Morbidite ve Mortalite ile �li�kili Risk Fakt�rleri [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. Bask�daki Makaleler: UTD-63764

Kolorektal Kanserin Acil Rezeksiyonlar�nda Morbidite ve Mortalite ile �li�kili Risk Fakt�rleri

Yasir Musa Kesgin¹, Turgut Donmez², Ahmet Surek¹, Ozden Canoz¹, Alpen Yahya Gumusoglu¹, Deniz Guzey¹, Mehmet Karabulut³
¹Sa�l�k Bilimleri �niversitesi, Bak�rk�y Dr. Sadi Konuk E�itim ve Ara�t�rma Hastanesi, Genel Cerrahi Klini�i, �stanbul, T�rkiye Istanbul, T�rkiye
²�stanbul Medipol Bah�elievler Hastanesi, Genel Cerrahi Klini�i
³�stanbul Medicana Atak�y Hastanesi, Genel Cerrahi Klini�i

Giri� ve Ama�: Erken tan� i�in g�sterilen t�m �abalara ra�men kolorektal kanser hastalar�n�n d�rtte biri hala acil �artlarda ameliyat edilmektedir. �al��mam�z�n amac� acil kolorektal kanser rezeksiyonlar�nda morbidite ve mortalite ile ili�kili risk fakt�rlerini ara�t�rmakt�r.

Y�ntem: Tek bir referans merkezde acil �artlarda yap�lan kolorektal kanser rezeksiyonlar�n�n retrospektif de�erlendirmesi ile yap�lan bu �al��mada hastalara ait demografik veriler, perioperatif �zellikler v edetaylar�n yan� s�ra t�m�r karakteristikleri incelendi. �al��mam�zda morbidite varl�� Clavien Dindo ≥3 komplikasyon olarak tan�mland�. Hem morbidite hem de mortalite a��s�ndan �nce tek de�i�kenli analizler ve ard�ndan �ok de�i�kenli lojistik regresyon testleri ile risk fakt�rleri ara�t�r�ld�
Bulgular: �al��mam�z %63�� (119 hasta) erkek olmak �zere toplam 188 hasta ile ger�ekle�tirildi. �ok de�i�kenli analizlerde morbidite riski ile ili�kili fakt�rler ya� (OR=3,02, p=0,009), ASA skoru (OR=1,01, p=0,049), ameliyat s�resi (OR=1,01, p=0,001) ve perforasyon varl��yd� (OR, 3,24, p=0,004). Mortalite i�in yap�lan �ok de�i�kenli analizde ya��n (OR, 3,23, p=0,017), ASA'n�n (OR, 5,92, p=0,009), ameliyat s�resinin (OR, 1,01, p=0,007) ve perforasyon varl��n�n (OR, 3,01, p=0,013) mortalite geli�imi ile anlaml� bir ili�kiye sahip oldu�u tespit edildi.

Sonu�: Bu �al��ma, acil kolorektal kanser rezeksiyonlar� ge�iren hastalarda morbidite ve mortaliteye katk�da bulunan birka� �nemli risk fakt�r�n� vurgulamaktad�r. Ya��n yetmi� �zerinde olmas�, �� ve �zerinde ASA skoru, ameliyat s�resinin uzun olmas� ve perforasyon varl�� hem morbidite hem de mortalite sonu�lar�n� k�t� etkileyen temel fakt�rler olarak belirlenmi�tir. Bu risk fakt�rlerinin erken tan�mlanmas�, daha y�ksek risk alt�ndaki hastalar�n belirlenmesi ve bu sayede hasta y�netiminin geli�tirilmesine imkan tan�yacakt�r. Y�ksek morbidite ve mortalite oranlar� g�z �n�ne al�nd��nda, kolorektal acillerde �zellikleaya�l� hastalara, daha y�ksek ASA skorlar�na sahip olanlara, ameliyat�n uzad�� ve perforasyon tespit edilmi� hastalar�n yak�ndan izlem ve daha dikkatli bir yo�un perioperatif bak�mdan fayda g�rebilece�i ak�lda tutulmal�d�r.

Anahtar Kelimeler: Morbidite, Mortalite, Kolorektal Kanser, Acil Cerrahi

Risk Factors Associated With Morbidity And Mortality In Emergency Colorectal Cancer Resections

Yasir Musa Kesgin¹, Turgut Donmez², Ahmet Surek¹, Ozden Canoz¹, Alpen Yahya Gumusoglu¹, Deniz Guzey¹, Mehmet Karabulut³
¹University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of General Surgery, Istanbul, T�rkiye
²Istanbul Medipol Bahcelievler Hospital, Department of General Surgery
³Istanbul Medicana Atakoy Hospital, Department of General Surgery

Introduction: Despite the efforts made for early diagnosis, approximately 25% of the colorectal cancer patients are still operated under emergency conditions. The aim of our study is to investigate the risk factors associated with morbidity and mortality in emergency colorectal cancer resections

Methods: Emergency colorectal cancer resections in a single center were included in this retrospective study. Baseline and operative data, tumor characteristics, were examined. Morbidity was defined as Clavien Dindo ≥3 complication. Risk factors for both morbidity and mortality were both evaluated with univariate analyzes and multivariable logistic regression tests

Results: The study was conducted with 188 patients, 119(63.3%) of whom were men. In multivariate analyzes, factors associated with morbidity risk were age (OR=3.02, p=0.009), ASA (OR=1.01, p=0.049), duration of surgery (OR=1.01, p=0.001), and presence of perforation (OR, 3.24, p=0.004). Multivariate analyzes for mortality showed significant effect of age (OR, 3.23, p=0.017), ASA (OR, 5.92, p=0.009), duration of operation (OR, 1.01, p=0.007) and the presence of perforation (OR, 3.01, p=0.013).

Conclusion: This study highlights several significant risk factors contributing to morbidity and mortality in patients undergoing emergency colorectal cancer resections. Age (>70), ASA score (≥3), duration of surgery, and presence of perforation were identified as key factors influencing both morbidity and mortality outcomes. Early identification of these risk factors could help in stratifying patients at higher risk and optimizing management strategies. Given the high morbidity and mortality rates associated with emergency resections, particular attention should be given to elderly patients, those with higher ASA scores, prolonged surgeries, and those with perforations, as these patients may benefit from more intensive perioperative care and closer monitoring.

Keywords: Morbidity, Mortality, Colorectal Cancer, Emergency Surgery

Sorumlu Yazar: Yasir Musa Kesgin, T�rkiye
Makale Dili: �ngilizce

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