Emergency surgery for obstructing XXXX : prognostic and risk factors.

@entity1 @entity5 @entity254 @entity3 @entity14
PURPOSE: Emergency surgery for colorectal malignant obstruction is thought to correlate with poor outcome. The main aim of our study was to identify possible factors that could predict obstruction, and risk factors of poor postoperative outcome. The second aim was to determine any differences between primary @entity254 and stoma creation in the obstruction population, especially in @entity5 . METHODS: A retrospective review of 212 @entity1 who underwent surgery for @entity14 between January 2008 and January 2013 was performed. Fifty-five @entity1 (26%) underwent emergency surgery for completely obstructing @entity14 , and 157 (74%) underwent elective surgery. RESULTS: The groups were comparable for age, gender, ASA score, @entity5 location, @entity5 stage, lymph node @entity3 and mortality. Advanced @entity5 stage was recorded as the only prognostic factor of obstruction (p=0.001). Postoperative mortality rate was 9.1% in the obstruction group and 6.4% in the elective group (p=0.498). Analysis didn't reveal any risk factors for poor early outcome in the obstruction group. All @entity1 with right-sided obstructive @entity5 were treated with resection and primary @entity254 , while the same procedure was performed in almost 61% of operations for @entity5 with no anastomotic failure. CONCLUSIONS: Obstructive @entity14 presents at a more advanced stage compared with @entity5 , with, interestingly, no statistically significant differences in postoperative mortality. Risk factors of poor early outcome couldn't be identified. Resection and primary restitution of continuity is the surgical approach of choice for right-sided obstructive @entity5 , but it can be, also, safely performed in left-sided @entity5 .
