Emergency surgery for abdominal oncologic patologies

SUMMARYThe aim of this study was , to predict the abdominal oncological pathologies, that needsemergency surgery for increasing the life qualıty and to investigate the risk factors ofmorbidity and mortality.The records of 203 patients, who underwent emergency surgery with the diagnosis ofcomplicated abdominal oncological disease between January -1996 and July-2006 inGeneral Surgey Department of Medical Faculty of Dicle University,had used.Age, sex, preoperative hematocrit and albumine levels, indication of surgery, surgicaltreatments which has been performed before admitance, ASA and Goldman scores and co-morbid disease were evaluated.Tumor, its? extension to other tissues and liver metastasis,peritonitis, the type of the operation were reported..Postoperative hospitalization time, datasof morbidity , mortality and histopathological diagnosis were recorded. The datas wereeveluated statisticaly by multivariate and univariate analysis.İn the study;one hundred and fifteen patients (%56,7) were male and 88 patients(%43,3)were female. The avarage of the age was 48,9±17,22.İleus(%62), perforation(%30), bleeding(%2,4) were most common emergency surgeryindication of abdominal oncological pathologies.İleus was the most common indication incolorectal cancers.On the other hand, perforation was the most common indication in stomachcancers. Ninety seven percentage of the patients were advanced stage.(stage 3,4)One hundred and twenty seven(%63) of the patients underwent paliative surgery, wherethe 76(%37) of them had underwent definitive surgery. Thirty two percentage of them hadcomplications and the most common complication was the infection of the wound.The rate of the mortality was %14,2. We have seen the peritonitis, co-morbidty, lowhematocrit levels , complication, high ASA and Goldman scores with mortality in univariateanalysis. On the other hand, the low hematocrit level and high ASA score were effected themortality statisticaly in binary logistics analysis.The avarage of the hospitalization time was 13,17±11,24 days.The patients,who hadmorbidty and mortality had longer hospitalized time than the others.Even if the methods in diagnosis were better, today the need of emergency surgery forabdominal oncological pathology is still a lot.İn our study in ten years ıt was %19.Early and prompt diagnosis of both the tumor itself and its?complications are essential inorder to decrease the rate of morbidty and mortality. Care should be shown especially topatients with high score of ASA and those with peritonitis and low hematocrit levels.