CLINICAL DIFFERENCES BETWEEN SURGICALLY TREATED PATIENTS WITH LARGE BOWEL OBSTRUCTION IN CITIES OF VAN AND ISTANBUL

AIMS: Geograpbical differences between cases of colonic obstructions affect clinical course and outcome of patients. We aimed to establish regional clinical differences between patients with colonic obstructionfrom eastern and western regions of Turkey.
METHODS: We retrospectively analysed 224 patients with colonic obstruction who were surgically treated in two hospital situated in Istanbul from western and in Van from eastern regions of Turkey. Tbis analysis was made in respect of demograpbic features, causes of obstruction and location in the colon, complicated obstructions, postoperative clinical course and mortality.
RESULTS: Men constituted 71.4% of patients with a mean age of 55.5 years. Obstruction site was the left colon in 82.5% and the sigmoid in 66% of patients from western region, and 91.7% (p=0.03), and 85% (p=0.007) respectivelyofthosesfrom eastern region. The leading causes of obstruction were obstructive cancer (52.5%) in istanbul and volvulus (80.2%) Van respectively (p< 0.001). The colonic obstruction was complicated in 22% of patients. The rate of complicated obstruction was 17.5% and 26.4% (p=0.07) in Van..espectively. The overall postoperative mortality was found as 12.9%. The mortality being 8.6% in simple obstruction raised to 28% (p=0.008) in complicated patients.
CONCLUSION: We found significant differences in colonic obstruction cases between eastern and western parts of Turkey. The incidence of complicated obstruction is bigher in eastern region. A considerable mortality arises in surgically treated patients with colonic obstruction. Postoperative mortality was significantly elevated in cases of obstruction complicated by strangulation, necrosis, and perforation.

VAN VE ISTANBUL ÝLLERÝNDE CERRAHÝ TEDAVÝ UYGULANAN AKUT KALIN BARSAK TIKANMALI OLGULAR ARASINDAKÝ KLÝNÝK FARKLAR