Clinical outcomes after surgery for benign stomach versus colorectal perforations

Free perforation of stomach or colorectum usually necessitates emergency surgery. Perforation is associated with short-term mortality and morbidity in up to 30% and 50% of patients, respectively, due to secondary peritonitis and sepsis. We hypothesized that postoperative clinical outcomes after colorectal perforation (CRP) are worse than those with stomach perforation (SP). This retrospective study aimed to compare the early postoperative clinical outcomes of patients with stomach and colorectal perforations, focusing on morbidity and mortality, and identify differences that could indicate potential changes in surgical management. Data from 214 patients who underwent surgery for stomach and colorectal perforations were retrospectively reviewed. We compared the demographic, intraoperative, and postoperative data, including morbidity and mortality during hospitalization of the two groups of patients. One group consisted of patients with SP, and the second group consisted of patients with CRP. The incidences of postoperative cardiac, gastrointestinal, and nephrological complications; sepsis; planned reoperation; reoperation due to complications; median operation time; median blood loss; and median hospital stay after surgery were significantly higher in patients with CRP than in those with SP. After adjusting for potential confounders such as BMI and nicotine use using a logistic regression model, we observed additional that the incidence of postoperative surgical complications was significantly higher in the CRP group compared to the SP group. Peritonitis was significantly more common in the SP group. In addition, overall medical complications and mortality were common in the total patient population and were higher in the CRP than in SP group; however, these differences were not statistically significant. Mortality and morbidity rates following surgery for SP and CRP were similar and often life threatening. However, patients with CRP experience worse clinical outcomes more often, indicating a more complex injury requiring considerably more medical intervention and extended treatment.