van Eeghen Elmer E, den Boer Frank C, Loffeld Ruud J L F
Department of Internal Medicine and Surgery, Zaans Medisch Centrum, Zaandam, The Netherlands.
J Gastrointest Oncol. 2015 Dec;6(6):613-7. doi: 10.3978/j.issn.2078-6891.2015.079.
The goal of surgery for colorectal cancer is cure. Unfortunately post-operative mortality occurs. This study aims to identify co-morbidity and causes of mortality in the post-operative period in relation to direct technical complications of surgery.
All consecutive patients who underwent surgery for colorectal cancer were included. Co-morbidity was determined via the Charlson co-morbidity score. The post-operative course was studied and cause of death within 30 days was determined. Patients were divided in two groups: group 1 died within 30 days after surgery and group 2 survived for longer than 30 days.
Twenty three out of 333 patients (6.9%) with colon cancer and 6 out of 112 (5.3%) with rectal cancer died in the post-operative period. Patients in group 1 were significantly older than patients in group 2 (P<0.001). Patients in group 1 with colon cancer also significantly had more often a higher stage of cancer (P=0.03). The Charlson co-morbidity score for patients with colon cancer in group 1 was mean 5.17 (SD 1.57, range, 1-8), and for rectal cancer mean 4.83 (SD 2.32, range, 2-7). There was no difference in Charlson co-morbidity score when patients from groups 1 and 2 were compared. In group 1, 13 (44%) died as a direct consequence of technical surgical complications. Sixteen patients died due to complications because of pre-existing co-morbidity.
Post-operative mortality very often is the direct result of pre-existing co-morbidity and not always the direct result of the surgical procedure.
结直肠癌手术的目标是治愈。不幸的是，术后死亡率依然存在。本研究旨在确定与手术直接技术并发症相关的术后合并症及死亡原因。
纳入所有连续接受结直肠癌手术的患者。通过查尔森合并症评分确定合并症情况。研究术后病程并确定30天内的死亡原因。患者分为两组：第1组在术后30天内死亡，第2组存活超过30天。
333例结肠癌患者中有23例（6.9%）、112例直肠癌患者中有6例（5.3%）在术后死亡。第1组患者比第2组患者年龄显著更大（P<0.001）。第1组结肠癌患者癌症分期较高的情况也更常见（P=0.03）。第1组结肠癌患者的查尔森合并症评分为平均5.17（标准差1.57，范围1 - 8），直肠癌患者为平均4.83（标准差2.32，范围2 - 7）。比较第1组和第2组患者时，查尔森合并症评分无差异。在第1组中，13例（44%）死于手术技术并发症的直接后果。16例患者因既有合并症引发的并发症死亡。
术后死亡往往是既有合并症的直接结果，而不总是手术操作的直接结果。
