SURGICAL SITE INFECTIONS AFTER EMERGENCY SURGICAL TREATMENT WITH RESECTION VS PROXIMAL STOMA IN OBSTRUCTIVE COLORECTAL CANCER: RETROSPECTIVE COHORT BEFORE-AND-AFTER STUDY
DOI: 10.22138/2500-0918-2018-15-6-800-807
A.G. Ponomarev, E.V. Nishnevich
City Clinical Hospital No. 40, Yekaterinburg, Russian Federation;
Ural State Medical University, Yekaterinburg, Russian Federation
Abstract. Objective. To determine the incidence of infectious postoperative complications in patients who underwent obstructive resection in comparison with ileo- / colostomy for tumor-associated acute colonic obstruction. Material and methods. Retrospective cohort studies, including the analysis before and after the intervention, were conducted. The studies included 297 patients operated for colorectal cancer in City Clinical Hospital No. 40 in Yekaterinburg. In 143 patients, urgent surgical intervention was performed in the volume of obstructive resection (control group), and in 154 patients in the volume of proximal ileo-/colostomy (main group). Results. In the group of patients operated under urgent conditions in the volume of proximal ileo-/colostomy, the number of infectious complications directly related to the operation was significantly lower, mainly due to the laparoscopic approach of surgical treatment. The mortality was not significantly different, but had an evident tendency to decrease in the group of patients who underwent damage control surgery, i.e., ileo-/colostomy. Conclusion. Urgent surgical intervention of proximal ileo-/colostomy for obstructing colorectal cancer in comparison with obstructive resection makes it possible to reduce the number of infectious complications in the postoperative period and can be considered as an operation of choice in conditions of limited medical resources. Laparoscopic technique, if it is possible to apply this approach, is the most optimal method of stoma formation.
Keywords: colorectal cancer, obstructing colorectal cancer, damage control, colorectal surgery, emergency surgery, surgical site infection, mortality
There is no conflict of interest.
Contact details of the corresponding author:
Alexander G. Ponomarev
ponomarev24@mail.ru
Received 08.10.2018
For citation:
Ponomarev A.G., Nishnevich E.V. Surgical site infections after emergency sur¬gical treatment with resection vs proximal stoma in obstructive colorectal cancer: retrospective co¬hort before-and-after study. Vestn. Ural. Med. Akad. Nauki. = Journal of Ural Medical Academic Science. 2018, Vol. 15, no. 6, pp. 800–807. DOI: 10.22138/2500-0918-2018-15-6-800-807 (In Russ).
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Authors:
Alexander G. Ponomarev
MD, Department of Colorectal Surgery,
City Clinical Hospital No. 40
189, Volgogradskaya str., Yekaterinburg,
Russian Federation, 620102
ponomarev24@mail.ru
Evgenii V. Nishnevich
Dr. Sci. (Med.), Head of Department of Surgery
City Clinical Hospital No. 40
189, Volgogradskaya str., Yekaterinburg,
Russian Federation 620102
14neva@gmail.com
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)