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Surgery Today

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01-11-2012 | Original Article

Colonic perforation due to colorectal cancer: predicting postoperative organ failure with a preoperative scoring system and selecting the optimal surgical method based on the prognosis

Authors: Hiroshi Sawayama, Shinjiro Tomiyasu, Kiichiro Kanemitsu, Takatsugu Matsumoto, Hideyuki Tanaka, Hideo Baba

Published in: Surgery Today | Issue 11/2012

Abstract

Purpose

The purpose of this study was to predict the postoperative organ derangement before surgery and to select the optimal surgical methods for a perforation due to colorectal cancer.

Methods

The Mannheim Peritonitis Index (MPI) was used to determine the preoperative status and Sequential Organ Failure Assessment (SOFA) score for postoperative status, retrospectively.

Results

There were 25 cases of colorectal cancer-related colon perforation. These patients were classified as having a preoperative MPI ≤ 29 or ≥ 30 and the mean postoperative SOFA scores were 2.30 ± 2.45 and 7.93 ± 3.45 (p = 0.0002), respectively. Seven of 20 patients who underwent tumor resection received a bowel anastomosis without a stoma. The MPI of these seven patients was low (23.1 ± 7.47) and there were no severe postoperative organ disorders (SOFA score 1.86 ± 2.26). Eighteen of the 25 patients had no distant metastasis. Eight of these 18 patients underwent lymph node (LN) dissection, including intermediate LNs, while the other 10 cases only had the pericolic/perirectal LNs dissected. The average preoperative MPI was 23.9 ± 7.68 and 32.8 ± 5.77, and the postoperative SOFA scores were 3.75 ± 3.01 and 7.10 ± 5.34, respectively.

Conclusion

The MPI could be used to predict postoperative organ disorders and thus represents a useful index that can be used to determine the optimal surgical methods.

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Title: Colonic perforation due to colorectal cancer: predicting postoperative organ failure with a preoperative scoring system and selecting the optimal surgical method based on the prognosis
Authors: Hiroshi Sawayama
Shinjiro Tomiyasu
Kiichiro Kanemitsu
Takatsugu Matsumoto
Hideyuki Tanaka
Hideo Baba
Publication date: 01-11-2012
Publisher: Springer Japan
Published in: Surgery Today / Issue 11/2012
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-012-0220-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Colonic perforation due to colorectal cancer: predicting postoperative organ failure with a preoperative scoring system and selecting the optimal surgical method based on the prognosis

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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