Riedl S, Wiebelt H, Bergmann U, Hermanek P
Chirurgische Universitätsklinik Heidelberg.
Chirurg. 1995 Jun;66(6):597-606.
In a prospective multicenter study an analysis of postoperative morbidity and mortality of 1224 patients with colon carcinoma treated in 7 departments of surgery was performed. The postoperative morbidity rate was 23.2% in elective surgery and 39.1% in emergency surgery. Postoperative mortality was 3.4% in elective cases and 11.6% in emergency cases. Preoperative associated diseases, which are more frequent in higher age, advanced tumor stage, and postoperative non-surgical complications rise operative mortality. However, surgical complications increase postoperative mortality only in cases of anastomotic leaks. The rates of postoperative complications depended on different surgical departments. Departments performing a delayed tumor resection in emergency surgery had better results. In elective cases the standard of oncological resections should be observed. In emergency cases operative procedure and extension of the resection should be planed in consideration of preoperative risk factors of the individual patient.
在一项前瞻性多中心研究中,对7个外科科室治疗的1224例结肠癌患者的术后发病率和死亡率进行了分析。择期手术的术后发病率为23.2%,急诊手术为39.1%。择期病例的术后死亡率为3.4%,急诊病例为11.6%。术前合并症在高龄、肿瘤晚期患者中更为常见,术后非手术并发症会增加手术死亡率。然而,手术并发症仅在吻合口漏的情况下会增加术后死亡率。术后并发症的发生率取决于不同的外科科室。在急诊手术中进行延迟肿瘤切除的科室效果更好。在择期病例中,应遵循肿瘤切除的标准。在急诊病例中,应根据个体患者的术前风险因素规划手术操作和切除范围。