Volvulus Of Colon Research Articles

Evaluating Racial Disparities in 30-day Outcomes for African Americans Following Colectomy for Volvulus.

Surgery is the definitive treatment for colonic volvulus despite initial decompression therapy. In general surgery, African Americans were found to have higher risks of mortality and morbidities. However, racial disparity in colectomy outcomes for volvulus among African Americans had not been explored. This study examined the 30-day outcomes for African Americans following colectomy for volvulus. The National Surgical Quality Improvement Program (NSQIP) targeted colectomy database from 2012 to 2022 was used. Only patients with volvulus as the primary indication for colectomy were selected. A 1:1 propensity score matching was applied to African Americans and Caucasians to match sex, age, baseline characteristics, preoperative preparation, indication for surgery (if emergent), and operative approaches. Thirty-day postoperative outcomes were examined. There were 1027 and 7451 African Americans and Caucasians who underwent colectomy for volvulus, respectively. All African Americans were 1:1 propensity-score matched to their Caucasian counterparts. African Americans and Caucasians had a comparable mortality rate (7.21% vs 7.89%, P = 0.62). While African Americans had a higher risk of pulmonary complications (16.85% vs 13.53%, P = 0.04), other surgical complications were all comparable between African Americans and Caucasians. However, African Americans had a longer time from admission to operation (2.70 ± 3.99 vs 2.17 ± 3.36days, P < 0.01) and a longer length of stay (LOS; 12.81 ± 10.28 vs 10.50 ± 7.72days, P < 0.01). African Americans were found to have higher risks of pulmonary complications, delayed operation, and extended LOS. These disparities raise concerns and warrant further investigation into their underlying causes. Effective targeted interventions may be necessary to address these issues.

Colonic torsion and volvulus in dogs is associated with a low mortality rate and good long-term outcome.

To describe clinical findings, complications, and short- and long-term outcomes associated with colonic torsion and volvulus in dogs. 28 client-owned dogs. Multi-institutional, retrospective study. Medical records were searched for dogs of any age, body weight, sex, and breed that underwent surgery for colonic torsion and volvulus. Collected data included signalment, previous history, preoperative findings, time until surgery, intraoperative findings, postoperative complications, length of hospitalization, survival to discharge, and outcomes. 28 dogs were included. Thirteen of 28 dogs (46.4%) had preexisting gastrointestinal conditions. Nine of 28 dogs (32.1%) had a gastropexy performed prior to presentation. Ten dogs (35.7%) were found to have a resolution of colonic torsion and volvulus at the time of the surgery. All but 1 dog (27 of 28 [96.4%]) survived to discharge. Two dogs died during the postoperative period, yielding a mortality rate of 7.1%. Postoperative complications were noted in 9 dogs (9 of 28 [32.1%]). Long-term follow-up information was available in 16 of 28 dogs (57%). Among 16 dogs with at least 6 months' follow-up, all dogs (16 of 16 [100%]) were alive at 6 months postoperatively. Two dogs developed mesenteric torsion after the initial surgery. Dogs with colonic torsion and volvulus undergoing surgery can have an excellent survival-to-discharge ratio with a low mortality rate. Surgeons should not be prompted to euthanize or assume a guarded prognosis solely on the basis of the intraoperative appearance of the bowel and should consider all factors prior to making decisions. Owners should be informed of the risk of developing further torsional diseases after surgery.

Clinical manifestations and quality of life in patients with different types of idiopathic megabowel

AIM: to compare the clinical and diagnostic features and quality of life in patients with different types of idiopathic megabowel. PATIENTS AND METHODS: 157 patients with idiopathic megacolon/megarectum, confirmed by barium enema, were divided on 3 groups: 1) distal idiopathic megabowel (megarectum ± distal third of sigmoid colon dilatation); 2) idiopathic megacolon (variable extent of colon dilatation with a normal size rectum); 3) idiopathic megabowel (megarectum ± variable extent of colon dilatation). Hirschsprung’s disease was excluded in all patients based on complex of clinical features, barium enema and anorectal manometry results and (if needed) rectal Swenson’s biopsy. RESULTS: the cohort included 70 (44.6 %) patients with distal idiopathic megabowel, 50 (31.8 %) patients with idiopathic megacolon and 37 (23.6 %) patients with idiopathic megabowel. Wexner constipation scale rate, rate of integral parameters “abdominal discomfort” and “defecation difficulties”, summary assessment of quality of life by IBSQOL questionnaire did not differ between groups (p &gt; 0.05). At the same time patients with distal idiopathic megabowel were statistically significant younger (p &lt; 0.01), had significant higher rate of faecal incontinence due to faecal impaction overflow (p &lt; 0.01), had less often bowel movement. Also these patients had significant higher rate of distal contrast retention (p &lt; 0.01) during gut transit test, but their colonic transit time was slight faster (p = 0.04).In multivariate analysis both megarectum (OR = 25.42; 95 % CI 5.01–128.92) and insufficiency of anal sphincter (OR = 4.71; 95 % CI 1.38–16.14) were independent predictors of faecal incontinence. The surgical treatment was performed most often in idiopathic megacolon group (p &lt; 0.01), mainly due to colon volvulus. The most patients with distal idiopathic megabowel (97.1 %) were successfully maintained with a conservative treatment. CONCLUSION: there was not substantial difference in clinical features and quality of life in patients with different types of idiopathic megabowel, except of significant higher rate of faecal incontinence and less often bowel movement in distal idiopathic megabowel group. Faecal incontinence in these patients is linked disturbance rather intestinal, than anal component of continence. The necessity in surgical treatment was rising most often in cases of idiopathic megacolon. The conservative treatment was quite effective in most patients with distal idiopathic megabowel.

Typology of Terminal Colon at the Chu of Point G in Bamako

Purpose: To describe the morphometric types of the terminal colon. Patients and Methods: This was an anatomical study by laparotomy for the terminal colon on 7 living subjects and by anatomical dissection on 8 fresh cadaveric subjects in the department of surgery B of the CHU of Point G and in the anatomy laboratory of the faculties of medicine of odonto-stomatology (FMOS) and pharmacy (FAPH) of Bamako from January 1, 2018 to December 31, 2019 or 2 years. Patients without a mass on the terminal recto-colonic junction or volvulus of the terminal colon or abdominopelvic mass on the terminal colon and fresh cadavers declared unknown without a laparotomy scar coming from Bamako University Hospitals or Reference Centers (CS Réf) were included in this study. Results: We investigated 15 cases, including 7 live cases and 8 cadavers. Males accounted for 60% (n=9) and females 40% (n=6), i.e. a sex ratio of 1.5. Mean age was 47.14 ±15.57 years. The mean length of the terminal colon was 41.79 cm±13.37. The mean length of the terminal mesocolon was 11.18 cm. The maximum height of the terminal mesocolon averaged 10.70 cm ± 3.61 cm. There were 46.72% (n=7) medium-form cases, 33.30% (n=5) short-form cases and 19.98% (n=3) long-form cases. Conclusion: The terminal colon can be short, medium or long, depending on its length and the height of its meso.

Flowmetry and spectrophotometry can detect reduced intestinal microperfusion in nonsurvivors during equine colic surgery for large intestinal strangulation.

To evaluate the use of laser Doppler flowmetry and spectrophotometry (LDFS) for large intestinal viability assessment in horses with naturally occurring large intestinal strangulations. By use of LDFS, intestinal microperfusion was quantified as tissue oxygen saturation (tSo2), hemoglobin (tHB), and blood flow (tBF) in cases with large colon volvulus and small colon strangulations undergoing colic surgery (n = 17). Intestinal biopsies were taken from the pelvic flexure in all large colon cases and in small colon cases that underwent intraoperative euthanasia. Measurements were compared between survivors and nonsurvivors, and the correlation between LDFS and (immuno)histology was tested (P < .05). The tSo2 and tBF were clearly lower and tHB was higher than previously reported in healthy horses. Following correction of the lesion, pelvic flexure tBF was significantly lower than that of the left ventral colon. Prior to correction of the lesion, microperfusion did not differ between survivors and nonsurvivors, but following release of the strangulation the survivors had a significantly higher tSo2 and tBF compared to the nonsurvivors. There was a negative correlation between tBF and interstitium-to-crypt ratio and a positive correlation between tHB and the histological hemorrhage score. There were no significant correlations between LDFS measurements and inflammatory cell counts or hypoxia-inducible factor-1α immunoreactivity. Large intestinal microperfusion was decreased in nonsurvivors compared to survivors and was correlated with histological injury, suggesting that LDFS has the potential to predict tissue injury and postoperative survival. The use of LDFS as an ancillary diagnostic aid may improve intraoperative viability assessment during colic surgery.

Ultrasound imaging of bowel obstruction in infants and children.

We review the etiologies of bowel obstruction in infants and children that can be identified on ultrasound (US) including perforated appendicitis, intussusception, foreign body ingestion, colonic volvulus, intra-abdominal mass lesions, internal hernia, and stricturing inflammatory bowel disease. US can potentially identify the cause of bowel obstruction in these age groups, without the need for additional cross-sectional imaging, and can aid in patient management including interventional and surgical planning. Hence, it is important to be familiar with the sonographic imaging findings of bowel obstruction in infants and children.

Sigmoid and cecum colon volvulus: a case report

IntroductionColon volvulus is the twisting of a segment of colon on its mesenteric axis, which can lead to the obstruction of the lumen and the blood supply. Colon volvulus is common in “volvulus belt” countries and can involve the sigmoid (60–70%) and cecum (25–40%).Case presentationWe report a case of a 47-year-old male, Alawites, who presented with bowel obstruction and dilated abdomen without any specific abdominal pain. Abdominal laparotomy showed both sigmoid and cecum volvulus with no signs of perforation or ischemia.Discussion and conclusionOne of the possible risk factors of sigmoid colon volvulus is the length of the rectum and sigmoid, while mobile cecum is considered as a possible reason for cecum volvulus. The management remains controversial and is specific for every case, depending mainly on the vitality of the colonic walls and the general condition of the patient.

Comments on “Clinicopathological Features of Elderly Patients with Colonic Volvulus”

Comments on “Clinicopathological Features of Elderly Patients with Colonic Volvulus”

Dependent functional status is an independent risk factor for 30-day mortality and morbidities following colectomy for volvulus: An ACS-NSQIP study from the United States

ObjectivesColonic volvulus is a common cause of bowel obstructions and surgery is the definitive treatment. Functional status is often associated with adverse postoperative outcomes but its effect on colectomy for volvulus remained under-explored. This study sought to analyze the effect of functional status on the 30-day outcomes of colectomy for volvulus. Materials and methodNational Surgical Quality Improvement Program (NSQIP) targeted colectomy database from 2012 to 2022 was utilized. Only patients with volvulus as the primary indication for colectomy were included. Thirty-day postoperative outcomes were compared between patients with dependent functional status (DFS) and independent functional status (IFS), adjusted for demographics, baseline characteristics, preoperative preparation, indication for surgery, and operative approaches by multivariable logistic regression. ResultsThere were 1,476 patients with DFS (945 partially DFS and 531 fully DFS) and 8,824 (85.67 %) IFS patients who underwent colectomy for volvulus. After multivariable analysis, DFS patients had higher risks of mortality (aOR=1.671, 95 CI=1.37–2.038, p < 0.01), pulmonary complications (aOR=2.166, 95 CI=1.85–2.536, p < 0.01), sepsis (aOR=1.31, 95 CI=1.107–1.551, p < 0.01), prolonged postoperative nothing by mouth (NPO) or nasogastric tube (NGT) use (aOR=1.436, 95 CI=1.269–1.626, p < 0.01), discharge not to home (aOR=3.774, 95 CI=3.23–4.411, p < 0.01), and 30-day readmission (aOR=1.196, 95 CI=1.007–1.42, p = 0.04). Moreover, DFS patients had a longer length of stay (p = 0.01). ConclusionDFS was identified as an independent risk factor for increased mortality and complications after colectomy for volvulus. Given the substantial overlap between DFS patients and those who have colonic volvulus, these insights can contribute to preoperative risk assessments and postoperative care in these patients.

Dexmedetomidine preconditioning reduces ischaemia-reperfusion injury in equine model of large colon volvulus.

Large colon volvulus is a cause of colic in horses with high morbidity and mortality when not promptly treated. More treatment options are needed to improve the outcome of these cases by protecting against the damage caused by ischaemia and reperfusion injury. To determine the effect of preconditioning with dexmedetomidine prior to induction of ischaemia-reperfusion (IR) injury in a large colon volvulus model in the horse. Randomised blinded in vivo experiments. Horses received either a dexmedetomidine (DEX) or saline (CON) constant rate infusion (CRI) immediately following induction of anaesthesia. Venous, arterial, and transmural occlusion of a section of the large colon was performed for 3 h, after which the ligatures and clamps were removed to allow for reperfusion for 3 h. Biopsies of the large colon were taken at baseline, 1 and 3 h of ischaemia, and at 1 and 3 h of reperfusion. The severity of crypt epithelial loss (DEX = 2.1 [0.8-2.8], CON = 3.1 [2.5-4], p = 0.03) and mucosal haemorrhage was decreased (DEX = 2.1 [1.3-3], CON = 3.5 [2.5-4], p = 0.03) in group DEX compared to group CON when graded on a scale of 0-4. Crypt length remained longer (DEX = 369.5 ± 91.7 μm, CON = 238.5 ± 72.6 μm, p = 0.02) and interstitium to crypt (I:C) ratio remained lower (DEX = 1.4 (1-1.7), CON = 2.6 [1.8-5.9], p = 0.03) in group DEX compared to group CON during reperfusion. Clinical applicability of pharmacologic preconditioning is limited. Preconditioning with a dexmedetomidine CRI prior to IR injury demonstrated a protective effect histologically on the large colon in the horse. Further investigation into postconditioning with dexmedetomidine is warranted as a possible intervention in colic cases suspected of being large colon volvulus.

Clinicopathological Features of Elderly Patients with Colonic Volvulus

Objective: Sigmoid volvulus is most commonly seen in patients between 60 and 80 years old. The management of volvulus depends on its location and clinical presentation. The fundamental aspects of treatment include evaluating the viability of the colon, relieving the obstruction, and preventing the possibility of recurrence. We aimed to present the clinicopathological characteristics of geriatric colonic volvulus patients treated in a single center. Methods: Patients diagnosed with colonic volvulus and treated in this hospital were included in the study. Mortality rates of patients who underwent and did not undergo preoperative colonoscopic detorsion were compared statistically. In addition, diseases that affect the quality of life and cause deterioration in bowel movements and habits were determined, and these diseases' effect on mortality was evaluated. Results: Forty-four patients who underwent emergency surgery due to volvulus were included in our study. There was sigmoid colon perforation in two patients and cecum perforation in 1 patient. Two patients had cecal volvulus, and right hemicolectomy was performed in these patients; anastomosis was performed in one, and ileostomy was performed in the other. Sigmoid resection was performed in 36 patients, subtotal colectomy in 5 patients, right hemicolectomy in 2 patients, and sigmoidopexy with laparotomy and reduction in 1 patient. Thirteen patients (29.5%) underwent preoperative colonoscopy, and in eight cases, the procedure was conducted a day before the surgery, with the operation being carried out semi-urgently the next day. Conclusion: Intestinal volvulus is a rare condition that can occur in any part of the large intestine. However, it is a severe medical issue that requires prompt diagnosis and treatment due to the possibility of intestinal damage and mortality.

A rare complication of pediatric liver transplantation: Post-transplant diaphragmatic hernia.

Acquired post-transplant diaphragmatic hernia (PTDH) is a rare complication of liver transplantation (LT) in children. We aimed to present our experience in PTDH, and a possible causative background is discussed. Medical records of patients who had undergone diaphragmatic repair following LT between 2015 and 2023 were reviewed. Demographic information, details of primary diseases necessitating LT, transplantation techniques, and clinical findings associated with PTDH were evaluated. There were seven patients with PTDH. Median age at transplantation was 69 (range: 9-200) months. Five patients received a left lateral sector, one patient had a right lobe, and one had a left lobe graft. Time between LT and PTDH was 9 (2-123) months. One patient who was diagnosed in the postoperative 10th year was asymptomatic. Respiratory distress and abdominal pain were the main symptoms among all. All patients underwent laparotomy, and primary repair was performed in six patients, and one patient required mesh repair because of a large defect. Small intestine herniated in most cases. There were two complicated cases with perforation of the stomach and colonic volvulus. There is no recurrence or long-term complications for the median 60 (20-119) month follow-up period. PTDH is a rare but serious complication. Majority of symptomatic cases present within the first postoperative year, whereas some late-presenting cases may not be symptomatic. Inadvertent injury to the inferior phrenic vasculatures due to excessive use of cauterization for control of hemostasis may be a plausible explanation in those cases.

Factors associated with development of post-operative reflux in horses with large colon volvulus and association with complications and outcomes.

Post-operative reflux (POR) is rare following large colon volvulus (LCV) but does occur despite the absence of a small intestinal lesion. The prevalence, risk factors and association with survival of POR after LCV are currently unknown. To determine the prevalence of POR in horses with an LCV and its association with survival. A further objective was to assess factors which may predict POR. The hypothesis was that horses with POR following LCV surgery have a worse outcome for survival compared to those without POR. A retrospective cross-sectional study. Clinical data of client owned horses which underwent colic surgery at a single UK referral hospital between 2008 and 2021, where LCV was the primary finding, were retrieved from hospital records. Statistical analyses included chi-squared, t-tests and odds ratios (ORs). Horses with concurrent lesions, and those that did not survive past anaesthetic recovery, were excluded from analysis. POR was defined as ≥2 L of gastric reflux on at least one occasion. A total of 128 horses were included in the study, 23 of which had POR (18%). Overall survival to hospital discharge was 86%, 95% in the non-POR and 44% in the POR group. Horses with POR were less likely to survive to discharge than those without (OR = 26, 95% confidence interval [CI] [7.68-88.0], p < 0.001), and less likely to be alive 3 years after surgery (OR = 13.4, 95% CI [2.78-64.8], p < 0.001). Due to the retrospective study design, full data sets were not available for every case because clinical records were incomplete or, at that time, certain tests were not performed or clinical variables were not measured. POR in LCV cases is a negative prognostic indicator for survival.

Experience with Laparoscopic and Robotic Colon Surgery Together with Other Major Minimally Invasive Procedures for Unrelated Pathologies.

Background: Indications for combined colon surgery together with other procedures include oncologic multivisceral resections and abdominal trauma. It is unclear if combining minimally invasive (MI) colon surgery with unrelated other procedures increases the risk for complications. Patients and Methods: The surgical database from two institutions during a 10-year period was queried for combined colon surgeries together with other interventions. All open cases, combined cases performed for one pathology and MI colectomies together with a minor procedure, were excluded. Results: Median age of the 6 men and 7 women was 64.4 (range 42.7-75.4) years. Colon surgeries included right (5), sigmoid (4) transverse (1) colectomies, rectum resection (1), rectopexy (1), and colostomy reversal (1) with indications of colorectal cancer (5), diverticulitis (3), benign ileocecal mass (1), colonic volvulus (3) and rectal prolapse (1). Second procedures included two splenectomies (sarcoidosis, ITP), paraesophageal hernia repairs (4), right diaphragmatic repairs [eventration (2) and Morgagni type hernia]; cholecystectomies (2), appendectomy (acute appendicitis), duodenal wedge resection (carcinoid), reversal of a gastric bypass (Roux limb stricture) one each. Cases were done laparoscopically (7) and robotic assisted (6). In most cases only 4 trocars were used. Median OR time was 4.3 (range 2.5 to 6.6) hours. No anastomotic breakdown was observed. Conclusions: Combining MI colectomy and other major abdominal surgeries can be safely done and in this series did not increase morbidity or mortality but avoids a second operation. Patient selection seems important and port placement may need to be altered to achieve good exposure for both procedures.

Volvulus of the gastrointestinal tract.

Volvulus describes the twisting of the intestine or colon around its mesentery. Intestinal obstruction and/or ischaemia are the most common complications of volvulus. Within the gastrointestinal tract, there is a preponderance towards colonic volvulus. The sigmoid is the most commonly affected segment, followed by the caecum, small intestine and stomach. Distinguishing between the differing anatomical locations of gastrointestinal volvulus can be challenging, but is important for the management and prognosis. This article focuses on the main anatomical sites of gastrointestinal volvulus encountered in clinical practice. The aetiology, presentation, radiological features and management options for each are discussed to highlight the key differences.

Volvulus of the Transverse Colon: Report of case and Review of the Literature

Volvulus of the Transverse Colon: Report of case and Review of the Literature

Immature Granulocyte Percentage as an Early Predictor of Necrosis in Volvulus.

Volvulus is a disease characterized by the abnormal twisting of a gaseous distension of the loop of the intestine around itself. Colonic volvulus is the third common cause of colonic obstruction. The study aimed to determine whether the percentage of immature granulocytes is a marker of early necrosis in the volvulus. Demographic characteristics of the cases were collected in the study. In addition, age, gender, white blood cell count, immature granulocyte count, immature granulocyte percentage, platelet lymphocyte ratio, and neutrophil-lymphocyte ratio were compared between groups with and without necrosis in terms of treatment. The effectiveness of immature granulocyte percentage (IG%) and IG markers were statistically significant in predicting necrosis. The AUC was the highest for IG (0.820, 95% CI: 0.586-1), followed by IG% (0.820, 95% CI: 0.617-1). The optimal cut-off value for the IG was 0.65, with a sensitivity of 76.2% and specificity of 85.7% (P = 0.013). The optimal cut-off value for the IG% was 0.065, with a sensitivity of 85.7% and specificity of 71.4% (0.018). IG% and IG count were found to be useful for predicting necrosis in patients with volvulus.

Mesenteric small cell lymphocytic lymphoma presenting as acute intestinal obstruction: A rare case scenario

Small-cell lymphocytic lymphoma is a rare type of B-cell non-Hodgkin lymphoma. It is known as one of the indolent lymphomas. Moreover, sigmoid volvulus as an initial presentation is extremely uncommon. We encountered a unique case of mesenteric small cell lymphocytic lymphoma that presented with sigmoid volvulus as the initial clinical presentation. A 55-year-old male presented with 7-day history of abdominal pain, abdominal distension for 6 days, and non-passage of stool and flatus with recurrent vomiting for 3 days. Abdominopelvic computed tomography revealed a distended small bowel with volvulus of sigmoid colon with twisting of its mesentery with inter-ileal as well as free peritoneal collections of fluid. A manual untwisting counterclockwise of the volvulus followed by resection and anastomosis at a point where the bowel has apparent normal thickness and color along with excisional biopsy of the enlarged lymph node. Histopathology confirmed the diagnosis of small-cell lymphocytic lymphoma. Mesenteric lymphomas are less likely to present with sigmoid volvulus as the initial clinical presentation due to their extraluminal location and also they are indolent in course. Early diagnosis and its management reduce morbidity and mortality.

Small Colon Faecalith with Large Colon Displacement in Ten Cases (2015-2023): A Detailed Case Description and Literature Review.

Small colon impaction can result in accumulation of ingesta, gas, and fluid orally to the impaction site in horses. Large colon tympany, which is caused by ingesta fermentation, can be a predisposing factor for intestinal displacement. The aim of this study is to report the history, clinical, and surgical findings of horses and ponies referred for abdominal pain not responsive to drugs where a right dorsal displacement (RDD) or large colon volvulus (LCV), together with a small colon faecalith (SCF), were diagnosed during surgery. This study included a total of five horses and five ponies. Based on clinical features, ultrasonographic examination, and rectal palpation, an initial suspected diagnosis of RDD, LCV or severe large colon and caecum distension was made in all clinical cases. Due to the lack of response to medical treatment or worsening of colic symptoms, surgery was performed in all horses: diagnosis of RDD or LCV was made and a SCF was incidentally detected in all cases. While exploratory laparotomy was carried out in all the patients for the presence of a large colon issue, it was probably subsequent to an obstruction of the small colon caused by the presence of an SCF, which is generally difficult to diagnose. This study reported the presence of SCF as a possible cause of secondary RDD or LCV in horses and ponies that, to the authors' knowledge, has never been reported.

Epidemiology and age-related trends in surgical outcomes for sigmoid volvulus: a 17-year analysis.

Sigmoid volvulus, a gastrointestinal disorder characterized by twisted bowel, often requires medical intervention, either through endoscopic or surgical means, to avoid potentially severe outcomes. This study examined the challenges elderly patients face in undergoing surgical treatment, encompassing both mortality and morbidity. Furthermore, it aimed to determine how medical practices and outcomes have changed over a period of 17 years. We utilized data from the National Surgical Quality Improvement Project, which covers the period from 2005 to 2021, to identify patients who underwent left hemicolectomy for colonic volvulus. The patients were categorized into three age groups: < 60 years, 60-75 years, and > 75 years. We performed a meticulous logistic regression analysis, carefully adjusted for risk factors, to compare mortality, morbidity, and types of surgical treatment administered among the different age groups. Our study included 6775 patients. The breakdown of the patient population was as follows: 2067 patients were < 60 years of age, 2239 were between 60 and 75 years of age, and 2469 were > 75 years of age. The elderly cohort, those agedabove 75 years, were predominantly male, had lower BMIs, underwent fewer laparoscopic surgeries, required more diverting stomas and end-ostomies, and had longer hospital stays. Notably, the elderly population faced a mortality risk that was 5.67 times (95% CI 3.64, 9.20) greater than that of their youngest counterparts, with this risk increasing by 10% (95% CI 1.06, 1.14) for each additional year of age. Furthermore, the odds of mortality associated with emergency surgery were 1.63 times (95% CI 1.21, 2.22) higher than those associated with elective surgery. The postoperative morbidity odds were also elevated for emergency surgeries, 1.30 times (95% CI 1.08, 1.58) greater than that for elective cases. Over the 17-year period, we observed a decline in mortality rates, an increase in the utilization of laparoscopic procedures, and overall stability of morbidity rates. Our findings highlight the increased vulnerability of patients over 75 years of age, who are not only at an elevated risk of mortality compared to their younger counterparts, but also a continuously increasing risk with age. By focusing on elective surgeries for younger patients and minimizing emergency surgeries for the elderly, it may be possible to reduce the mortality risk associated with surgical interventions in this population.