G. P. ANGELUCCI ET AL.
Open Access SS
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ticulous fluid and electrolyte therapy, and the involve-
ment of a multidisciplinary team comprehensive of an-
esthesiologist for the understanding of the pre-existing
comorbidities that are involved in the morbidity of the
patients [12]. Age was non-related with the morbidity
and mortality. Patients with ASA grade >2, or cardio-
vascular disease and/or respiratory disease had higher
incidence of morbidity and experienced longer recovery
in Intensive Care Unit. Four of them died for heart failure,
and one for respiratory failure.
It is also demonstrated a significant ongoing risk of
SBO after colorectal surgery, mainly during the 1st year
after surgery. It is usually associated with the adhesions
formation, especially after open surgery [13]. We had
two cases of postoperative ileus and one patient experi-
enced a SBO treated with no oral intake, gastric tube and
fluid therapy. The diagnosis of SBO was based on clini-
cal and imaging criteria. Current practice for manage-
ment of SBO is to give patients who are clinically stable
and without evidence of bowel ischemia or strangulation
a trial of conservative manage ment. Previously published
data suggest that 43% to 70% of these patients have
resolution of their SBO [14].
5. Conclusions
Our study is a retrospective case review, focusing on
how comorbidities can influence the outcome of the pa-
tients and on the management of the surgical complica-
tion. The limit of our clinical records is related to the
short-term follow-up, the number of the patients, and the
few patients treated with a laparoscopic approach.
In our experience, we evidenced that surgery perfor-
med for advanced rectal cancer in the lower rectum, es-
pecially in urgency settings is associated with an increase
of morbidity and mortality in the early post-operative
period, higher than colonic resections.
Pre-existing comorbidities are involved in the morbid-
ity of the patients: obesity, diabetes, cardiovascular dis-
ease, respiratory disease and renal failure. And a more
accurate approach both in surgical technique and in
post-operative management can be proposed to the sur-
geon. In our experience, age per-se is not a serious inde-
pendent risk factor unless the patient has one of the pre-
vious comorbidities.
It seems that derivative stoma in high risk patients
does not decrease the incidence of AL, but may give us
the possibility of a conservative treatment with antibiot-
ics and CT-drainage.
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