大腸穿孔手術症例の検討

概要

論文の詳細を見る
A retrospective analysis was conducted to clarify the clinicopathological factors and prognosis of surgery for colorectal perforation (excluding appendicular perforation). Subjects comprised 24 patients (17 men, 7 women) with a mean age of 67.9 years. Causes of perforation were diverticula (n=9), cancer (n=7), iatrogenic (n=3), injury (n=2), ischemia (n=2) or drug-induced (n=1). Site of perforation was the sigmoid colon (n=14), rectum (n=3), transverse colon (n=4), ascending colon (n=2) or cecum (n=1). All patients who died within 30 days after surgery had displayed perforation of the sigmoid colon or rectum. Significant differences in base excess and blood pressure were identified between patients who died within 30 days after surgery and survivors. Factors such as male gender, decreased white blood cell count and non-covered perforation were associated with poor prognosis. Mortality rate within 30 days was 20.8%. Patients who died within 30 days experienced severe complications such as multiple organ failure, sepsis and acute myocardial infarction. In cases of perforated colon cancer, median survival was 91 days in curative cases, and 23 days in non-curative cases. One long-term survivor was identified in curative cases. Hypotension and decreased base excess may be useful as indicators for severity of general condition. Curative surgery for colorectal cancer can allow long-term survival even in perforated cases.
新潟大学の論文
2006-03-10