Management of complications in colorectal surgery

Summary Background Complications in colorectal surgery inevitably occur. Especially emergency surgery is associated with worse outcomes and connected with higher failure to rescue. The aim of this study was to assess surgical and nonsurgical complications and their management in colorectal surgery. Methods This study comprises a retrospective data collection among patients undergoing colorectal surgery between 2020 and 2022 at the Kepler University Hospital in Austria. Emergency and elective right-sided hemicolectomy, left-sided hemicolectomy, and rectal resection were included. Results A total of 407 patients (male 49.8%; mean age 63 years) were included. Of these, 127 patients (31.2%) underwent right-sided hemicolectomy, 181 patients (44.5%) left-sided hemicolectomy, and 99 patients (24.3%) rectal resection; 62 patients (15.2%) had emergency index surgery, and they showed significantly higher morbidity than patients undergoing elective surgery (P < 0.001). Surgical complications occurred in 59 patients (14.5%), nonsurgical complications in 68 patients (16.7%). The reoperation rate was 16.1% after emergency and 8.7% after elective surgery (P = 0.059). Conclusion This study highlights complications in three common colorectal procedures. Surgical complications showed the highest morbidity and mortality rates in patients undergoing right-sided hemicolectomy. Nonsurgical complications demonstrated the highest morbidity in the right-sided hemicolectomy group, while mortality was most pronounced in patients undergoing rectal resection. While innovations have improved colorectal complication management, enhanced preoperative optimization in emergency settings is essential. Patient stratification considering surgical morbidity and quality of life is crucial for further outcome improvements.