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Abstract
The most common urgent complication of colorectal cancer is acute intestinal obstruction recorded in 20–40% of patients with malignant colon neoplasms. One of the independent negative prognostic factors affecting results of surgical treatment in patients with obstructive colonic obstruction is the level of the primary somatic status. The comorbid background determines the severity of the course of the disease and increases risks of postoperative adverse events and death.
Aim. Evaluation of the effect of organ dysfunction measured with the prognostic scales SAPS 2, SOFA and ASA on the results of surgical treatment of patients with tumor colonic obstruction.
Materials and methods. A retrospective cohort analysis of the results of surgical treatment for colorectal cancer complicated by obstructive colonic obstruction was performed in 110 patients. The inclusion criterion was the decompensation stage of the intestinal obstruction. The exclusion criteria from the study were: patients with other or combined complications of colorectal cancer, rectal tumors, and patients with obstructive intestinal obstruction of tumoral genesis at the stage of compensation and subcompensation. The relation between the results of the ASA, SOFA and SAPS 2 score scales on the risk of postoperative complications and hospital mortality within 30 days after surgery was studied. Statistical processing of materials was performed on the basis of StatTech v. 2.5.9 software As the statistically significant level, p≤0.05 was considered.
Results. Our study has revealed a statistically significant impact of the SAPS 2 score on the incidence of postoperative complications and the outcome of surgical treatment (p<0.001). Cutoff value of the SAPS 2 indicator after which lethal outcomes were noted was established as 39 after assessing the sensitivity and specificity of the SAPS 2, scale.
Conclusion. It is necessary to develop an optimized surgical approach that would take into account not only the localization of the obstruction, but also the severity of organ dysfunction for improving the results of treatment of the acute tumor intestinal obstruction. This can be achieved with the use of various score scales. SAPS II scale statistically significantly correlates with the frequency of postoperative complications and the outcome of surgical treatment for tumor colonic obstruction.
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