Non-malignant left colon emergency surgery: evaluation of factors affecting clinical outcomes and complications.

BACKGROUND: Emergency colorectal resections hold a significant position in general surgical practice, and pathologies of the left colon are relatively common. This study was conducted to assess the outcomes of isolated left colon surgeries with benign etiologies, drawing on clinicopathological and biochemical data.

METHODS: We carried out a retrospective review and statistical analysis of demographic, clinical, and laboratory data of patients who underwent left colon surgery at the general surgery clinic of a tertiary care hospital, excluding those with malignancy-related emergencies, from January 2017 to January 2022.

RESULTS: The average age of the 48 patients in the study was 56.9±16.4 years. Complicated acute diverticulitis was the most frequent indication for emergency surgery (n=19, 39.6%). The Hartmann procedure was the surgical technique most often employed (n=30, 62.5%). The rates of postoperative morbidity and mortality within 30 days were 27.1% and 8.3%, respectively. Increased postoperative morbidity was linked to advanced age (mean 65.4±15.8 vs. 53.8±15.7, p=0.028), the preoperative administration of vasopressors, lower platelet counts, hypoalbuminemia (<3 mg/dl), and azotemia (blood urea nitrogen >20 mg/dl). There was no statistically significant correlation between comorbidities, American Society of Anesthesiologists (ASA) scores, surgical methods, or other clinical data and postoperative outcomes.

CONCLUSION: For emergency colorectal surgery pertaining to left colon pathologies, it is critical to conduct a comprehensive evaluation in the perioperative period, especially for elderly and hypotensive patients with renal function abnormalities and for those requiring vasopressors.