Effect of Malignancy on Morbidity and Mortality in Left-Sided Emergency Colorectal Resections

Introduction: Despite technological developments, morbidity and mortality in emergency colorectal surgery remain high.Despite efforts to diagnose colorectal cancer early, more than 20% of patients still undergo emergency surgery.How do outcomes in these patients differ from outcomes in patients with benign disease?Very few studies provide information on this subject; therefore, the aim of our study was to determine the effects of malignancy in patients who have undergone left-sided emergency colorectal resections.Methods: Patients undergoing emergency left-sided colectomy at a single tertiary hospital were included in this observational study.Demographics, Charlson comorbidity index, perforation, duration of surgery, preference for primary anastomosis or end colostomy, and benign or malignant etiologies were all examined.Morbidity was defined as a Clavien-Dindo grade III or higher complication.Risk factors for both morbidity and mortality were first evaluated using univariate analyses.Multivariable logistic regression analyses were then performed for both morbidity and mortality.Results: The study included 76 patients, 46 (60.5%) of whom were men.The mean age was 61.5 years, and the most common cause was colorectal cancer (n=46, 60%).Perforation was observed in 32.8% of patients (n=25), and obstruction in 38.1% of patients (n=29).The morbidity rate was 27.6% and the 90-day mortality rate was 15.7%.In univariate tests and multivariable regression analyses, malignancy was not associated with morbidity (p=0.879,p=0.711) or mortality (p=0.416,p=0.453).In both univariate and multivariable analyses, perforation was the only factor significantly related to morbidity and mortality.Conclusion: Malignancy was not identified as a direct cause of morbidity and mortality in emergency left-sided colectomies.Perforation was significantly associated with morbidity and mortality.In these high-risk surgeries, multicenter studies with larger patient groups are needed to detect causes of deterioration and to improve outcomes.