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Surg Today ; 42(11): 1082-7, 2012 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-22714796

RESUMEN

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.


Asunto(s)
Colon/cirugía , Neoplasias Colorrectales/complicaciones , Perforación Intestinal/cirugía , Insuficiencia Multiorgánica/diagnóstico , Puntuaciones en la Disfunción de Órganos , Cuidados Preoperatorios/métodos , Anciano , Anciano de 80 o más Años , Anastomosis Quirúrgica/efectos adversos , Anastomosis Quirúrgica/métodos , Estudios de Cohortes , Colectomía/efectos adversos , Colectomía/métodos , Colon/patología , Neoplasias Colorrectales/patología , Neoplasias Colorrectales/cirugía , Femenino , Mortalidad Hospitalaria/tendencias , Humanos , Perforación Intestinal/etiología , Perforación Intestinal/mortalidad , Ganglios Linfáticos/patología , Masculino , Persona de Mediana Edad , Insuficiencia Multiorgánica/etiología , Insuficiencia Multiorgánica/mortalidad , Estadificación de Neoplasias , Selección de Paciente , Complicaciones Posoperatorias/mortalidad , Complicaciones Posoperatorias/fisiopatología , Valor Predictivo de las Pruebas , Pronóstico , Estudios Retrospectivos , Medición de Riesgo , Tasa de Supervivencia , Resultado del Tratamiento
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