Department of General Surgery, Sincan Training and Research Hospital, Ankara-Türkiye.
Department of General Surgery, University of Health Sciences, Gülhane Training and Research Hospital, Ankara-Türkiye.
Ulus Travma Acil Cerrahi Derg. 2024 Apr;30(4):290-296. doi: 10.14744/tjtes.2024.40009.
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.
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.
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.
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.
急诊结直肠切除术在普通外科实践中占有重要地位，左半结肠病变相对常见。本研究旨在评估良性病因的孤立性左半结肠手术的结果，参考临床病理和生化数据。
我们对 2017 年 1 月至 2022 年 1 月在一家三级护理医院普外科接受左半结肠手术的患者的人口统计学、临床和实验室数据进行回顾性回顾和统计分析，排除与恶性肿瘤相关的急诊患者。
研究中的 48 例患者的平均年龄为 56.9±16.4 岁。复杂急性憩室炎是急诊手术最常见的指征（n=19，39.6%）。最常采用的手术技术是 Hartmann 手术（n=30，62.5%）。术后 30 天内的发病率和死亡率分别为 27.1%和 8.3%。术后发病率增加与年龄较大（平均 65.4±15.8 岁比 53.8±15.7 岁，p=0.028）、术前使用血管加压素、血小板计数较低、低白蛋白血症（<3mg/dl）和氮血症（血尿素氮>20mg/dl）有关。合并症、美国麻醉师协会（ASA）评分、手术方法或其他临床数据与术后结果之间无统计学显著相关性。
对于左半结肠病变的紧急结直肠手术，围手术期进行全面评估至关重要，特别是对于肾功能异常且需要血管加压素的老年和低血压患者。
