Author/Authors :
Sugimoto, Kiichi Department of Coloproctological Surgery - Juntendo University - Faculty of Medicine - Tokyo 113-8421, Japan , Sakamoto, Kazuhiro Department of Coloproctological Surgery - Juntendo University - Faculty of Medicine - Tokyo 113-8421, Japan , Okazawa, Yu Department of Coloproctological Surgery - Juntendo University - Faculty of Medicine - Tokyo 113-8421, Japan , Takahashi, Rina Department of Coloproctological Surgery - Juntendo University - Faculty of Medicine - Tokyo 113-8421, Japan , Mizukoshi, Kosuke Department of Coloproctological Surgery - Juntendo University - Faculty of Medicine - Tokyo 113-8421, Japan , Ro, Hisashi Department of Coloproctological Surgery - Juntendo University - Faculty of Medicine - Tokyo 113-8421, Japan , Kawai, Masaya Department of Coloproctological Surgery - Juntendo University - Faculty of Medicine - Tokyo 113-8421, Japan , Kawano, Shingo Department of Coloproctological Surgery - Juntendo University - Faculty of Medicine - Tokyo 113-8421, Japan , Munakata, Shinya Department of Coloproctological Surgery - Juntendo University - Faculty of Medicine - Tokyo 113-8421, Japan , Ishiyama, Shun Department of Coloproctological Surgery - Juntendo University - Faculty of Medicine - Tokyo 113-8421, Japan , Kamiyama, Hirohiko Department of Coloproctological Surgery - Juntendo University - Faculty of Medicine - Tokyo 113-8421, Japan , Takahashi, Makoto Department of Coloproctological Surgery - Juntendo University - Faculty of Medicine - Tokyo 113-8421, Japan , Kojima, Yutaka Department of Coloproctological Surgery - Juntendo University - Faculty of Medicine - Tokyo 113-8421, Japan , Tomiki, Yuichi Department of Coloproctological Surgery - Juntendo University - Faculty of Medicine - Tokyo 113-8421, Japan , Tamura, Naoto Department of Rheumatology - Juntendo University - Faculty of Medicine - Tokyo 113-8421, Japan
Abstract :
Purpose. The goal of this retrospective study was to identify prognostic factors associated with mortality after surgery for colorectal perforation among patients with connective tissue disease (CTD) and to review postoperative outcomes based on these prognostic
factors. Methods. The subjects were 105 patients (CTD group: n=26, 24.8%; non-CTD group: n=79, 75.2%) who underwent
surgery for colorectal perforation at our department. Cases with iatrogenic perforation due to colonoscopic examination were
excluded from the study. We retrospectively investigated perioperative clinicopathological factors in patients undergoing surgery
for colorectal perforation. Results. Tere were 7 patients (6.7%) who died within 28 days afer surgery in all patients. In multivariate
analysis, CTD and fecal peritonitis emerged as signifcant independent prognostic factors (p=0.005, odds ratio=12.39; p=0.04, odds
ratio=7.10, respectively). Tere were 5 patients (19.2%) who died within 28 days afer surgery in the CTD group. In multivariate
analysis, fecal peritonitis emerged as a signifcant independent prognostic factor in the CTD group (p=0.03, odds ratio=31.96).
Te cumulative survival curve in the CTD group was signifcantly worse than that in the non-CTD group (p=0.006). An analysis
based on the presence of fecal peritonitis indicated no signifcant diference in cumulative survival curves for patients without fecal
peritonitis in the CTD and non-CTD groups (p=0.55) but a signifcant diference in these curves for patients with fecal peritonitis
in the two groups (p<0.0001). Conclusions. Tis study demonstrated that cumulative survival in patients with CTD is signifcantly worse than that in patients without CTD after surgery for colorectal perforation.
