Comparative study for colorectal patology in two different countries: Romania and Italy

Abstract

Introduction: Colorectal surgery refers to a variety of procedures used to repair damage to the colon, rectum, anus and pelvic floor caused by diseases of the lower digestive tract, such as cancer, diverticulitis and inflammatory bowel disease. Materials and Methods: One thousand consecutive patients who undergone colorectal surgery, at the Department of general surgery and emergency of the University of Bologna, St.Orsola Hospital, were included in this retrospective study (Group l).These patients were compared with the last 1000 patients who had colorectal surgery at Clinical County Hospital of Targu Mures (Group 2). The parameters analyzed included: age, sex, type of disease, type of presentation of the disease, TNM score and grading for malignant disease, emergency or elective surgery, type of operation, curative or palliative surgery, type of surgical approach(laparoscopy or laparotomy), mechanical or manual anastomosis, duration of operation, blood loss, transfusions, operative morbidity, mortality and hospital length of stay. SPSS statistical software was used for all statistical analyses. Results: Significant differences between the two groups were found within the incidence of different diseases: in Group 1, patients operated for cancers were the majority with a percentage of 48,06%,while diverticular disease was found in 13,87% of patients. In Group 2, cancers were 74,0% while diverticular disease was less representative with a percentage of 2,5%. This could be probably be explained by differences in dietary habits within the patients in the two groups. There were no statistically significant differences in mortality, morbidity and hospital stay between the two groups. Post-operative 30-day mortality, morbidity for all causes and hospital length of stay were respectively 3,69%, 32,88% (urgency: 42,39%, elective: 28,64%) and 9,67 days (urgency: 10,29; elective: 9,42) in Group 1, while were 6,7%, 25,1% (urgency: 11,74% elective: 13,08%) and 11,12 (urgency: 5,25; elective: 5,86) days in group 2. However the percentage of palliative operation was higher in group 2 probably because of a more delayed diagnosis. This could be explained with the use of an accurate local program of colonic cancers screening that take place in Bologna. Conclusions: The results of study show that colorectal pathology and surgery complication of these two countries are very similar, without representative differences, just a higher frequency of diverticular disease in Italy and a problem of screening for colorectal cancer in Romania.