Surgical treatment to aid patients with colorectal perforation.

BACKGROUND When a patient with colorectal perforation is treated, there is no adequate information about what the best procedure for emergent operation is. In the present study, we examined the clinical features in hemodialysis (HD) and non-HD patients with colorectal perforations. PATIENTS AND METHODS Forty-four patients (8 HD and 36 non-HD patients) who underwent surgery for colorectal perforation at the Fukuoka Red Cross Hospital were reviewed and analyzed. RESULTS Poor prognostic factors for patients with colorectal perforation were high age, HD, idiopathic perforation, postoperative complication and Hartmann's operation procedure. Good prognostic factors were diverticulum perforation and operation with anastomosis. In the analysis between HD and non-HD patients, clinical characteristics in HD patients with colorectal perforation were advanced age and rectal perforation. CONCLUSION High mortality rate of HD patients with colorectal perforation may be due to high age and rectal perforation in which cases it is technically difficult to perform operation. In case of emergent operation of colorectal perforation, the Hartmann's procedure may not be recommended.