Research Article
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Retrospective Analysis of 53 Cases who Developed Colon Fistula

Year 2022, Volume: 14 Issue: 1, 1 - 6, 30.06.2022
https://doi.org/10.56484/iamr.1049718

Abstract

Objective:
Colon cancer is among the most common cancers in men and women. Separation of anastomosis after resection is undesirable. There are various risk factors affecting the development of anastomotic leakage.

Methods:
Fifty-three cases of colon anastomotic leakage were included in the study retrospectively. Demographic characteristics and co-morbidities in these patients were evaluated retrospectively and risk factors were compared with the literature.

Results:
Additional disease was detected in thirty of fifty-three cases. The most common co-morbidities are diabetes mellitus (DM) and hypertension (HT), while less frequent chronic diseases such as chronic obstructive pulmonary disease (COPD) have been detected. Mortality rate is 11% in patients who develop fistula, and DM and HT usually coexist in mortal cases.

Conclusion:
Inadequate alveolar ventilation and consequently hypoxia and hypercapnia have negative effects on tissue repair processes in patients with COPD. Changes in the microcirculation and the patient's greater susceptibility to diabetes mellitus (DM)-related infection are risk factors for the development of postoperative fistula. If obesity is present together with DM, the risk of anastomotic leakage may be even higher. Preoperative diastolic pressure is another factor that increases the risk of anastomotic leakage. In conclusion, hypertension, obesity, diabetes, COPD are effective risk factors for anastomotic leakage after colorectal surgery. These risk factors are effective in increased morbidity and mortality.
Keywords: colon, cancer, anastomosis, leakage, fistula 

Supporting Institution

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References

  • Ahmed M.Colon cancer: a clinician’s perspective in 2019. Gastroenterology research, 2020, 13.1: 1.
  • Martinez, J. L., Luque-de-Leon, E., Mier, J. et al. Systematic management of postoperative enterocutaneous fistulas: factors related to outcomes. World journal of surgery, 2008, 32.3: 436-443.
  • de Vries, F. E., Atema, J. J., van Ruler, O., et al. A systematic review and meta-analysis of timing and outcome of intestinal failure surgery in patients with enteric fistula. World journal of surgery, 2018, 42.3: 695-706.
  • Topdagi O, Timuroglu A. Eighteen Years' Retrospective Review of Colorectal Cancer Cases in Eastern Population. Eurasian J Med. 2018 ;50(1):19-22.
  • Anthonysaamy; M. A; Gotra, I. M; Saputra , H. Prevalence of colorectal carcinoma based on microscopic type, sex, age and anatomical location in Sanglah General Hospital. Intisari Sains Medis, 2020; 11: 272-276.
  • Nguyen, L. H., Ma, W., Wang, D. D. , et al. Association between sulfur-metabolizing bacterial communities in stool and risk of distal colorectal cancer in men. Gastroenterology 2020;158.5: 1313-1325.
  • Idigoras Rubio, I., Arana-Arri, E., Portillo Villares, I et al. Participation in a population-based screening for colorectal cancer using the faecal immunochemical test decreases mortality in 5 years. European journal of gastroenterology & hepatology 2019;31.2 : 197-204. Zhang, Z., Wang, A., Tang, X , et al. Comparative mutational analysis of distal colon cancer with rectal cancer. Oncology letters 2020;19.3 : 1781-1788.
  • Ryan, É. J., Creavin, B., Sheahan, K. . Delivery of personalized care for locally advanced rectal cancer: incorporating pathological, molecular genetic, and immunological biomarkers into the multimodal paradigm. Frontiers in Oncology 2020;10: 1369.
  • Buchs, N. C., Gervaz, P., Secic, M. et al. Incidence, consequences, and risk factors for anastomotic dehiscence after colorectal surgery: a prospective monocentric study. Int J Colorectal Dis 2008; 23.3: 265-270
  • Ruggiero, R., Sparavigna, L., Docimo, G , et al. Post-operative peritonitis due to anastomotic dehiscence after colonic resection. Multicentric experience, retrospective analysis of risk factors and review of the literature. Ital Chir, 2011; 82: 369-375.
  • Testini M, Miniello S, Piccinni G, at al. Correlazioni tra broncopatia cronica ostruttiva e deiscenza dell'anastomosi colica in età geriatrica (Correlation between chronic obstructive bronchial disease and colonic anastomosis dehiscence in the elderly). Ann Ital Chir. 2003;74(3):247-50.
  • Sakr, A., Emile, S. H., Abdallah, E et al. Predictive factors for small intestinal and colonic anastomotic leak: a multivariate analysis. Indian Journal of Surgery, 2017;79.6: 555-562.
  • Lin X, Li J, Chen W, at al. Diabetes and risk of anastomotic leakage after gastrointestinal surgery. J Surg Res. 2015;196(2):294-301.
  • Post IL, Verheijen PM, Pronk A, at al. Intraoperative blood pressure changes as a risk factor for anastomotic leakage in colorectal surgery. Int J Colorectal Dis. 2012;27(6):765-772.
  • Telem DA, Chin EH, Nguyen SQ, at al. Risk Factors for Anastomotic Leak Following Colorectal Surgery: A Case-Control Study. Arch Surg. 2010;145(4):371-376.
Year 2022, Volume: 14 Issue: 1, 1 - 6, 30.06.2022
https://doi.org/10.56484/iamr.1049718

Abstract

Özet: Objektif: Kolon kanseri kadın ve erkeklerde sık görülen kanserler arasındadır. Rezeksiyon sonrası anastomoz ayrılması istenmeyen bir durumdur. Anastomoz kaçağı gelişmesine etkili çeşitli risk faktörleri vardır.
Metod: Elliüç kolon anastomoz kaçağı olgusu retrospektif olarak çalışmada yer almıştır. Bu hastalarda demografik özellikler ve yandaş hastalıklar retrospektif olarak değerlendirilmiş ve risk faktörleri literatür ile karşılaştırılmıştır.
Sonuçlar: Elliüç olgudan otuz vakada ek hastalık tespit edilmiştir. En çok tespit edilen yandaş hastalık diabetes mellitus(DM) ve hipertansiyon(HT) olup daha az sıklıkta ise kronik obstruktif akciğer hastalığı( KOAH) vb kronik hastalıklar tespit edilmiştir. Fistül gelişen hastalarda mortalite oranı %11 olup mortal olgularda genellikle DM ve HT birliktelik göstermektedir.
Tartışma: KOAH'lı hastalarda yetersiz alveoler ventilasyon ve bunun sonucunda hipoksi ve hiperkapni, doku onarım süreçlerinde olumsuz etkiye sahiptir. Mikro sirkülasyondaki değişiklikler ve hastanın diyabetes mellitus (DM) ile ilişkili enfeksiyona daha fazla duyarlılığı postoperatif fistül gelişiminde risk faktörüdür. DM ile birlikte obezite de mevcut ise anastomoz kaçak riski daha da yüksek olabiliyor. Preoperativ diastolik yüksek basınç , anastomoz kaçak riskini arttıran diğer bir faktördür. Sonuç olarak hipertansiyon, obezite, diabet, KOAH , kolorektal cerrahi sonrası anastomoz kaçaklarında etkili risk faktörleridir. Bu risk faktörleri morbidite ve mortalite artışında etkili olmaktadır. 

References

  • Ahmed M.Colon cancer: a clinician’s perspective in 2019. Gastroenterology research, 2020, 13.1: 1.
  • Martinez, J. L., Luque-de-Leon, E., Mier, J. et al. Systematic management of postoperative enterocutaneous fistulas: factors related to outcomes. World journal of surgery, 2008, 32.3: 436-443.
  • de Vries, F. E., Atema, J. J., van Ruler, O., et al. A systematic review and meta-analysis of timing and outcome of intestinal failure surgery in patients with enteric fistula. World journal of surgery, 2018, 42.3: 695-706.
  • Topdagi O, Timuroglu A. Eighteen Years' Retrospective Review of Colorectal Cancer Cases in Eastern Population. Eurasian J Med. 2018 ;50(1):19-22.
  • Anthonysaamy; M. A; Gotra, I. M; Saputra , H. Prevalence of colorectal carcinoma based on microscopic type, sex, age and anatomical location in Sanglah General Hospital. Intisari Sains Medis, 2020; 11: 272-276.
  • Nguyen, L. H., Ma, W., Wang, D. D. , et al. Association between sulfur-metabolizing bacterial communities in stool and risk of distal colorectal cancer in men. Gastroenterology 2020;158.5: 1313-1325.
  • Idigoras Rubio, I., Arana-Arri, E., Portillo Villares, I et al. Participation in a population-based screening for colorectal cancer using the faecal immunochemical test decreases mortality in 5 years. European journal of gastroenterology & hepatology 2019;31.2 : 197-204. Zhang, Z., Wang, A., Tang, X , et al. Comparative mutational analysis of distal colon cancer with rectal cancer. Oncology letters 2020;19.3 : 1781-1788.
  • Ryan, É. J., Creavin, B., Sheahan, K. . Delivery of personalized care for locally advanced rectal cancer: incorporating pathological, molecular genetic, and immunological biomarkers into the multimodal paradigm. Frontiers in Oncology 2020;10: 1369.
  • Buchs, N. C., Gervaz, P., Secic, M. et al. Incidence, consequences, and risk factors for anastomotic dehiscence after colorectal surgery: a prospective monocentric study. Int J Colorectal Dis 2008; 23.3: 265-270
  • Ruggiero, R., Sparavigna, L., Docimo, G , et al. Post-operative peritonitis due to anastomotic dehiscence after colonic resection. Multicentric experience, retrospective analysis of risk factors and review of the literature. Ital Chir, 2011; 82: 369-375.
  • Testini M, Miniello S, Piccinni G, at al. Correlazioni tra broncopatia cronica ostruttiva e deiscenza dell'anastomosi colica in età geriatrica (Correlation between chronic obstructive bronchial disease and colonic anastomosis dehiscence in the elderly). Ann Ital Chir. 2003;74(3):247-50.
  • Sakr, A., Emile, S. H., Abdallah, E et al. Predictive factors for small intestinal and colonic anastomotic leak: a multivariate analysis. Indian Journal of Surgery, 2017;79.6: 555-562.
  • Lin X, Li J, Chen W, at al. Diabetes and risk of anastomotic leakage after gastrointestinal surgery. J Surg Res. 2015;196(2):294-301.
  • Post IL, Verheijen PM, Pronk A, at al. Intraoperative blood pressure changes as a risk factor for anastomotic leakage in colorectal surgery. Int J Colorectal Dis. 2012;27(6):765-772.
  • Telem DA, Chin EH, Nguyen SQ, at al. Risk Factors for Anastomotic Leak Following Colorectal Surgery: A Case-Control Study. Arch Surg. 2010;145(4):371-376.
There are 15 citations in total.

Details

Primary Language English
Subjects Surgery
Journal Section Original Research Paper
Authors

Ömer Engin 0000-0002-6597-1970

Ayberk Dursun 0000-0001-9187-0463

Emre Turgut This is me 0000-0001-8196-1871

Publication Date June 30, 2022
Published in Issue Year 2022 Volume: 14 Issue: 1

Cite

APA Engin, Ö., Dursun, A., & Turgut, E. (2022). Retrospective Analysis of 53 Cases who Developed Colon Fistula. International Archives of Medical Research, 14(1), 1-6. https://doi.org/10.56484/iamr.1049718
AMA Engin Ö, Dursun A, Turgut E. Retrospective Analysis of 53 Cases who Developed Colon Fistula. IAMR. June 2022;14(1):1-6. doi:10.56484/iamr.1049718
Chicago Engin, Ömer, Ayberk Dursun, and Emre Turgut. “Retrospective Analysis of 53 Cases Who Developed Colon Fistula”. International Archives of Medical Research 14, no. 1 (June 2022): 1-6. https://doi.org/10.56484/iamr.1049718.
EndNote Engin Ö, Dursun A, Turgut E (June 1, 2022) Retrospective Analysis of 53 Cases who Developed Colon Fistula. International Archives of Medical Research 14 1 1–6.
IEEE Ö. Engin, A. Dursun, and E. Turgut, “Retrospective Analysis of 53 Cases who Developed Colon Fistula”, IAMR, vol. 14, no. 1, pp. 1–6, 2022, doi: 10.56484/iamr.1049718.
ISNAD Engin, Ömer et al. “Retrospective Analysis of 53 Cases Who Developed Colon Fistula”. International Archives of Medical Research 14/1 (June 2022), 1-6. https://doi.org/10.56484/iamr.1049718.
JAMA Engin Ö, Dursun A, Turgut E. Retrospective Analysis of 53 Cases who Developed Colon Fistula. IAMR. 2022;14:1–6.
MLA Engin, Ömer et al. “Retrospective Analysis of 53 Cases Who Developed Colon Fistula”. International Archives of Medical Research, vol. 14, no. 1, 2022, pp. 1-6, doi:10.56484/iamr.1049718.
Vancouver Engin Ö, Dursun A, Turgut E. Retrospective Analysis of 53 Cases who Developed Colon Fistula. IAMR. 2022;14(1):1-6.

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