大腸穿孔67例の検討

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We experienced 67 patients with colorectal perforation between June 1963 and Sep. 1989. Factors which could affect the prognosis including (1) age (2) underlying disease (3) operative method (4) interval between perforation and operation and (5) bacteriological investigation were discussed. The motality rate in all cases was 25.3 %, while it was 45.8 % in the cases with malignant disease and further increased to 55 % in the cases with malignant disease aged 60 years or more. Out of five patients with idiopathic perforation, three died. Conversely, the survival rate in the cases not influenced by malignant disease, except for idiopathic perforation, was very high (92 %). There are some reports describing that the survival rate increases as the interval between perforation and operation decreases. However, we experienced a different result, that is, the mortality in the cases with a long interval between perforation and operation was lower. The reason of this discrepancy seems to be that the cases with a shorter interval included many malignant and idiopathic cases. We concluded that such factors as (1) underlying disease which caused perforation, and (2) the patient's physical condition were more important in evaluating the prognosis of patients with colorectal perforation than the interval between perforation and operation.
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