Acute colonic ischemia following elective colectomy for cancer: Risk factors and outcomes.
Postoperative colonic ischemia is associated with far higher odds of in-hospital death.
Acute colonic ischemia following elective colectomy for cancer: Risk factors and outcomes.
Postoperative colonic ischemia is a rare but life-threatening complication after colectomy.
We sought to describe risk factors, procedure-specific associations, and outcomes of postoperative colonic ischemia in patients undergoing elective colectomy for colorectal cancer.
The National Inpatient Sample (2005-2019) was queried for adults undergoing elective colectomy for colorectal cancer.
postoperative colonic ischemia raises the odds of dying in the hospital
Among 192,637 patients (mean age, 65 years; 52% female; 79% White, 10% Black, and 6% Hispanic), Postoperative colonic ischemia occurred in 0.27% (n = 514).
Patients with postoperative colonic ischemia had a higher median Charlson Comorbidity Index (3, interquartile range, 2-5) than those without (2, interquartile range, 2-4; P < .001).
Incidence varied by resection type, with the highest rates after left hemicolectomy (0.52%), transverse colectomy (0.47%), and ileocecectomy (0.42%), compared with right hemicolectomy (0.28%), sigmoidectomy (0.14%), and low anterior resection (0.19%) (P < .001).
Although uncommon, postoperative colonic ischemia is a catastrophic complication after colectomy for colorectal cancer.
Risk is strongly associated with vascular comorbidities and resection type, with left hemicolectomy, transverse colectomy, and ileocecectomy carrying the highest observed incidence.
Risk stratification, selective vessel preservation, and intraoperative perfusion assessment may reduce ischemia-related morbidity and mortality.