Surgical outcomes in elderly patients with obstructed colorectal cancer: Single center experience

Öz

Aim: Colorectal cancer is the most common cause of large bowel ob-struction in elderly. The aim of this study is to compare the clinical findings and perioperative outcomes of elder and younger colorectal cancer patients who were urgently operated for obstruction in our de-partment. Material and Method: The files of patients who underwent emergency surgery for acute mechanical bowel obstruction due to colorectal cancer between January 2015 and December 2019 at the Sakarya University School of Medicine, Department of General Surgery were retrospective-ly reviewed. Results: A total of 187 patients who had emergency operation due to colorectal cancer-related obstruction in a 5-year period were included. 55.6% (n = 104) were over the age of 65, 46.4% (n = 83) were under the age of 65. ASA scores, tumor localization, and mean total hospital stay, duration of intensive care were statistically different between the two groups (p <0.05, p <0.022, p = 0.011). No significant difference de-tected in terms of mortality (p = 0.103). Conclusion: Obstructive colorectal cancers in geriatric patients who re-quire emergency surgery form a more challenging group than the elec-tive conditions. Our study shows that similar outcomes can be achieved in terms of postoperative complications, early mortality and oncological principles; with the younger cohort.

Anahtar Kelimeler

• colorectal cancer
• elderly
• emergency surgery
• large bowel obstruction

Obstruksiyona neden olmuş kolorektal kanserli yaşlı hastalarda acil cerrahi sonuçları: Tek merkez deneyimi

Öz

Amaç: Kolorektal kanserler, yaşlılarda kalın bağırsak tıkanıklığının en yaygın nedenidir. Bu çalışmanın amacı, bölümümüzde acil olarak ob-strüksiyon nedeniyle ameliyat edilen yaşlı ve genç kolorektal kanserli hastaların klinik bulgularını ve perioperatif sonuçlarını karşılaştırmaktır. Gereç ve Yöntem: Sakarya Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı'nda Ocak 2015-Aralık 2019 tarihleri arasında kolorektal kansere bağlı akut mekanik barsak tıkanıklığı nedeniyle acil ameliyat edilen hastaların dosyaları retrospektif olarak incelendi. Bulgular: 5 yıllık sürede kolorektal kansere bağlı tıkanıklık nedeniyle acil ameliyat olmuş toplam 187 hasta dahil edildi. % 55,6'sı (n = 104) 65 yaş üzerinde,% 46,4'ü (n = 83) 65 yaşın altındaydı. ASA skorları, tümör lokalizasyonu ve ortalama toplam hastanede kalış süresi, yoğun bakım süresi iki grup arasında istatistiksel olarak farklıydı (p <0.05, p <0.022, p = 0.011). Mortalite açısından gruplar arasında anlamlı bir fark saptanmadı (p = 0.103). Sonuç: Acil cerrahi gerektiren geriatrik hastalarda obstrüktif kolorektal kanserler, seçici koşullara göre daha zorlayıcı bir grup oluşturmaktadır. Çalışmamız, geriatrik gruptaki hastalarda postoperatif komplikasyonlar, erken mortalite ve onkolojik prensipler açısından genç grup ile benzer sonuçların elde edilebileceğini göstermektedir.

Anahtar Kelimeler

• kolorektal kanser
• yaşlı
• acil cerrahi
• kalınbarsak tıkanıklığı

Kaynakça

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