Anorectal disease in neutropenic leukemic patients: Operative vs. nonoperative management Journal Article
| Authors: | Grewal, H.; Guillem, J. G.; Quan, S. H. Q.; Enker, W. E.; Cohen, A. M. |
| Article Title: | Anorectal disease in neutropenic leukemic patients: Operative vs. nonoperative management |
| Abstract: | PURPOSE: This study was designed to evaluate the spectrum, clinical presentation, management, and outcome of anorectal disease in neutropenic leukemic patients and to compare operative and nonoperative management in neutropenic leukemic patients. METHODS: A retrospective review of hospital records was performed. RESULTS: One hundred fifty-one of 2,618 (5.8 percent) patients hospitalized with leukemia had concomitant symptomatic anorectal disease. Data from 81 patients were available for analysis. Fifty-two (64 percent) were treated nonoperatively and 29 (36 percent) underwent operative treatment. Fifty-seven (70.4 percent) had absolute neutrophil counts <1,000/ mm3, and 54 (66.7 percent) were severely neutropenic (absolute neutrophil count <500/mm3). Management and outcomes of 54 severely neutropenic patients were analyzed. In 20 patients who underwent surgery there were 4 deaths (20 percent) and 4 recurrences (20 percent), whereas in 34 patients managed nonoperatively there were 6 deaths (18 percent) and 4 recurrences (12 percent) (P>0.05). CONCLUSIONS: Symptomatic anorectal disease afflicted 5.8 percent of hospitalized leukemic patients. In these patients, anorectal sepsis was a major source of mortality. Our data suggest that anorectal abscesses in neutropenic leukemic patients may be safely drained. Because we did not observe excessive morbidity or mortality (20 percentvs.18 percent) in the operated neutropenic leukemics as compared with the nonoperated patients, selected neutropenic leukemic patients should not be denied anorectal surgery when otherwise indicated. © 1994 American Society of Colon and Rectal Surgeons. |
| Keywords: | adolescent; adult; child; preschool child; school child; treatment outcome; aged; child, preschool; leukemia; survival rate; retrospective studies; major clinical study; clinical feature; clinical trial; neutropenia; comparative study; recurrence; severity of illness index; infant; echography; recurrent disease; sepsis; surgical mortality; neutrophils; leukocyte count; anorectal disease; middle age; rectal diseases; perianal abscess; human; male; female; article; support, non-u.s. gov't; anorectal abscess |
| Journal Title: | Diseases of the Colon and Rectum |
| Volume: | 37 |
| Issue: | 11 |
| ISSN: | 0012-3706 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 1994-11-01 |
| Start Page: | 1095 |
| End Page: | 1099 |
| Language: | English |
| DOI: | 10.1007/bf02049810 |
| PROVIDER: | scopus |
| PUBMED: | 7956576 |
| DOI/URL: | |
| Notes: | Export Date: 14 January 2019 -- Article -- Source: Scopus |
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