RESUMEN
PURPOSE: To compare the Colorectal Physiological and Operative Score for enUmeration of Mortality and Morbidity (Cr-POSSUM) with the original Association of Coloproctology of Great Britain and Ireland (ACPGBI) and new ACPGBI scoring systems for their ability to predict mortality after colorectal cancer surgery. METHODS: We retrospectively calculated the Cr-POSSUM,original ACPBGI and new ACPGBI scores of 105 patients who underwent colorectal cancer surgery. Data were obtained from patients' medical records and operative notes.Mortality was defined as death within 30 days of surgery.Scores were validated by assessing their calibration and discrimination. Calibration was assessed using the Hosmer-Leme show test and corresponding calibration curves. The discriminative capability of the models was evaluated using receiver operating characteristic (ROC) curve analysis. RESULTS: The observed mortality rate was 4.8 %. The over all estimated risks of death of the Cr-POSSUM, original ACPGBI, and new ACPGBI scores were 9.92%, 7.35% and 4.20%, respectively. The results of areas under the curve(AUC) for Cr-POSSUM, original ACPGBI and new ACPGBI scores were 0.792, 0.844 and 0.801 respectively. CONCLUSIONS: The Cr-POSSUM, original ACPGBI and new ACPGBI scoring syStems are accurate in determining mortality rates and for predicting the risks of death in individual patients. The new and original ACPGBI scoring systems performed slightly better than the Cr-POSSUM scoring system.
Asunto(s)
Colectomía , Neoplasias Colorrectales/mortalidad , Neoplasias Colorrectales/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Colectomía/mortalidad , Neoplasias Colorrectales/diagnóstico , Femenino , Indicadores de Salud , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Valor Predictivo de las Pruebas , Curva ROC , Reproducibilidad de los Resultados , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Sensibilidad y Especificidad , Tasa de Supervivencia , Resultado del Tratamiento , Turquía/epidemiologíaRESUMEN
AIM: There is no definitive consensus on the best treatment for pilonidal sinus. The Bascom cleft lift technique has been reported to produce successful results. This study presents the results of a modified cleft lift procedure in which the sinus tissue was excised and the lower end of the incision was kept outside the intergluteal sulcus by extending the lower end of the incision laterally. METHOD: Between August 2010 and January 2012, 141 consecutive patients who presented with primary or recurrent pilonidal sinus disease were included in the study, which was conducted at a single tertiary academic medical centre. Prospectively collected data were recorded, including complications, pain score, satisfaction level, primary healing rate, length of hospital stay and early recurrence. RESULTS: The mean operating time was 30 min and the mean length of hospital stay was 1.2 days. The most common surgical-site complication was a collection followed by partial wound dehiscence and superficial infection. The primary healing rate was 88%, the mean time for functional recovery was 13 days and the mean follow-up time was 14 months. No recurrence was observed within this follow-up period. CONCLUSION: The modified Bascom cleft lift technique is effective and reliable. It is applicable to all pilonidal sinus cases and has low complication rates, high satisfaction scores, rapid early recovery and low recurrence rates.