Alhassan Noura S, Bin Traiki Thamer A, Alshammari Sulaiman A, Makkawi Mohaned, Alkhayyal Yazeed A, Alswayyed Mohammed A, Abdulla Maha-Hamadien, Zubaidi Ahmad M, Al-Obeed Omar A, Alharbi Reem A, AlKhayal Khayal A
Department of Surgery, College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia.
Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Saudi J Gastroenterol. 2025 Jul 1;31(4):233-240. doi: 10.4103/sjg.sjg_101_25. Epub 2025 Jun 6.
Presentation affects several surgical parameters and post-operative outcomes. This study compares emergency versus elective colon cancer outcomes and prognostic factors associated with postoperative complications.
All colon cancer patients who underwent curative resection between July 2015 and December 2019 were retrospectively reviewed and analyzed. Patients were divided into emergency and elective groups based on their presentation.
A total of 215 patients were included; 70 patients (32.6%) in the emergency group. Of them, 61 patients presented with obstruction, and nine with free perforation. The elective group had a higher laparoscopic approach (82.8%) with primary anastomosis (90.3%) compared to the emergency group (57.1% and 68.6%, respectively, P < 0.001). Postoperative complications were clinically higher in the emergency group (30% vs. 20.7%, P = 0.171). ICU/HDU admission was higher in the emergency group (40% vs. 17.2%, P < 0.001), and had a longer hospital stay (15 vs. 10 days, P < 0.003). Regression analysis revealed increased risk of complications among patients with comorbidities (OR 3.21; 95% CI, P = 0.002), albumin levels <30g/dl (OR 2.20; 95% CI, P = 0.01), complete obstruction (OR 2.42; 95% CI, P = 0.017), perforation (OR 9.98; 95% CI, P < 0.001), and open surgery (OR 4.84; 95% CI, P < 0.001).
Emergency presentation rate was high among our patients with less-favorable surgical outcomes. Open surgery and stoma creation were more prevalent in the emergency group. Complete obstruction, perforation, open surgery, hypo-albuminemia, and presence of comorbidities were independent risk factors for complications.
疾病表现会影响多个手术参数及术后结局。本研究比较了急诊与择期结肠癌手术的结局以及与术后并发症相关的预后因素。
回顾性分析2015年7月至2019年12月期间所有接受根治性切除术的结肠癌患者。根据疾病表现将患者分为急诊组和择期组。
共纳入215例患者；急诊组70例（32.6%）。其中，61例患者表现为肠梗阻，9例为游离穿孔。与急诊组（分别为57.1%和68.6%，P < 0.001）相比，择期组采用腹腔镜手术的比例更高（82.8%）且一期吻合的比例更高（90.3%）。急诊组术后并发症的临床发生率更高（30%对20.7%，P = 0.171）。急诊组入住重症监护病房/高依赖病房的比例更高（40%对17.2%，P < 0.001），且住院时间更长（15天对10天，P < 0.003）。回归分析显示，合并症患者（比值比3.21；95%置信区间，P = 0.002）、白蛋白水平<30g/dl（比值比2.20；95%置信区间，P = 0.01）、完全性梗阻（比值比2.42；95%置信区间，P = 0.017）、穿孔（比值比9.98；95%置信区间，P < 0.001）以及开放手术（比值比4.84；95%置信区间，P < 0.001）的患者发生并发症的风险增加。
在我们的患者中急诊就诊率较高，手术结局较差。开放手术和造口术在急诊组更为普遍。完全性梗阻、穿孔、开放手术、低白蛋白血症以及合并症是并发症的独立危险因素。
