Brunner Maximilian, Gärtner Lara, Weiß Andreas, Weber Klaus, Denz Axel, Krautz Christian, Weber Georg F, Grützmann Robert
Department of General and Visceral Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Krankenhausstraße 12, 91054 Erlangen, Germany.
J Clin Med. 2024 Sep 3;13(17):5220. doi: 10.3390/jcm13175220.
: This study aimed to determine the risk factors associated with postoperative major morbidity, anastomotic/suture leakage, re-surgery and mortality in patients undergoing emergency surgery for colonic perforation. : A total of 204 adult patients treated surgically for colonic perforation from 2016 to 2021 at the University Hospital Erlangen were included in a retrospective analysis. Patient demographics and pre-, intra- and postoperative parameters were obtained and evaluated among various outcome groups (in-hospital major morbidity, anastomotic/suture leakage, re-surgery and 90-day mortality). : Postoperative in-hospital major morbidity, anastomotic/suture leakage, need of re-surgery and 90-day mortality occurred in 45%, 12%, 25% and 12% of the included patients, respectively. Independent risk factors for in-hospital major morbidity were identified and included the presence of any comorbidity, a significantly reduced preoperative general condition, the localization of perforation in the right hemicolon and the need for an intraoperative blood transfusion. The only independent risk factor for anastomotic/suture leakage was the presence of any comorbidity, whereas no independent risk factors for re-surgery were found. An age > 65 years, a significantly reduced preoperative general condition and the need for an intraoperative blood transfusion were independent risk factors for 90-day mortality. : Our study identified risk factors impacting postoperative outcomes in patients undergoing emergency surgery for colonic perforation. These patients should receive enhanced postoperative care and may benefit from individualized and targeted therapeutic approaches.
本研究旨在确定结肠穿孔急诊手术患者术后主要并发症、吻合口/缝线漏、再次手术及死亡的相关危险因素。对2016年至2021年在埃尔朗根大学医院接受手术治疗的204例成年结肠穿孔患者进行回顾性分析。收集并评估了不同结局组（院内主要并发症、吻合口/缝线漏、再次手术和90天死亡率）患者的人口统计学资料以及术前、术中和术后参数。纳入患者中，术后院内主要并发症、吻合口/缝线漏、再次手术需求和90天死亡率的发生率分别为45%、12%、25%和12%。确定了院内主要并发症的独立危险因素，包括存在任何合并症、术前一般状况显著降低、穿孔位于右半结肠以及术中需要输血。吻合口/缝线漏的唯一独立危险因素是存在任何合并症，而未发现再次手术的独立危险因素。年龄>65岁、术前一般状况显著降低和术中需要输血是90天死亡率的独立危险因素。我们的研究确定了影响结肠穿孔急诊手术患者术后结局的危险因素。这些患者应接受强化术后护理，并可能从个体化和有针对性的治疗方法中获益。
