Gastroenterology

To study morbidity and mortality related to ileostomy/colostomy closure at tertiary care hospital (2024)

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Type of publication:
Journal article

Author(s):
Gilani S.S.; *Shahzeb M.; Salman D.M.; Nadeem M.; Khan S.; Thomas J.J.; Almesri A.

Citation:
Journal of Population Therapeutics and Clinical Pharmacology. 31(8) (pp 853-858), 2024. Date of Publication: 01 Aug 2024.

Abstract:
Background and Aim: Gastrointestinal stomas main function is to divert the flow away from a difficult anastomoses or intestinal obstruction. There is now a trend toward avoiding permanent stomas, and temporary loop stomas often used to protect anastomotic or distal bowel segments in high-risk patients. The present study aimed to determine the morbidity-mortality after ileostomy or colostomy closure. Patients and Methods: This comparative observational study investigated 42 cases of ileostomy and colostomy closure in the Surgical Unit of Jinnah Hospital, Lahore from January 2020 to January 2024. Patients were divided into two groups; Group-I (Ileostomy closure) and Group-II (Colostomy closure). Demographic details such as age and gender, Clinical details such as indications, types of stoma technique used, and operative times, length of hospital stay, morbidity, and mortality recorded. SPSS version 26 was used for data analysis. Result(s): The overall mean age was 46.8+/-6.52 years (15-75 years). Out of 42 cases, 28 (66.7%) underwent ileostomy and 14 (33.3%) underwent colostomy closure. The most prevalent indication for closure was protection of anastomosis in both stoma groups. The interval between creation and closure of stoma was shorter (117.8 days) in Group-I than Group-II (162.4 days). The incidence of hand sewing sutures and stapled technique was 32 (76.2%) and 10 (23.8%), respectively. The Group-II patients took 107.9+/-5.24 minutes as operative time which was significantly higher than 82.96+/-8.84 minutes in Group-I. The prevalence of morbidity in Group-I and Group-II was 10.7% (n=3) and 14.3% (n=2), respectively. Prolong hospital stay was required in Group-II. No mortality case reported in both stoma groups. Conclusion(s): The present study observed that Stomatal closure well tolerated procedure, with low morbidity and mortality. The results suggest that ileostomy closure is a relatively simple procedure.

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Effect of Alvimopan on Postoperative Ileus and Length of Hospital Stay in Patients Undergoing Bowel Resection: A Systematic Review and Meta-Analysis. (2024)

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Type of publication:
Systematic Review

Author(s):
Murtaza, Rashid; Clarke, Olivia; Sivakanthan, Tharshan; Al-Sarireh, Hashim; Al-Sarireh, Ahmad; Raza, Muhammad Musa; *Navid, Ahmad Zia; Ali, Baqar; Hajibandeh, Shahin; Hajibandeh, Shahab

Citation:
American Surgeon. 31348241265149, 2024 Jul 20 [epub ahead of print]

Abstract:
AIMS: The aim is to investigate the effect of alvimopan on postoperative ileus and length of hospital stay in patients undergoing bowel resection. METHODS: The PRISMA statement standards were followed to conduct a systematic review and meta-analysis. The available literature was searched to identify all studies comparing alvimopan with no alvimopan in patients undergoing bowel resection. Postoperative ileus and length of hospital stay were the primary outcomes, and time to first bowel motion was the secondary outcome. Random-effects modeling was applied for analyses. RESULTS: Analysis of 94 833 patients from 26 studies showed that alvimopan was associated with lower risk of postoperative ileus (OR: .57, 95% CI .48 to .67, P <.00001; high GRADE certainty), shorter length of hospital stay (MD: -1.08 day, 95% CI -1.36 to -.81, P < .00001; moderate GRADE certainty), and shorter time to first bowel motion (MD: -.43 day, 95% CI -.58 to -.28, P < .00001; moderate GRADE certainty). Separate analyses of randomized controlled trials and observational studies showed similar findings. Subgroup analyses suggested consistent findings in patients undergoing elective bowel resection, emergency bowel resection, and open surgery; however, alvimopan did not improve the outcomes in patients undergoing minimally invasive surgery. CONCLUSION: Robust evidence supports the routine use of alvimopan in patients undergoing open bowel resection as indicated by lower risk of postoperative ileus and shorter length of hospital stay. We support incorporation of alvimopan into enhanced recovery after surgery programs for the procedures involving open bowel resection. The role of alvimopan in minimally invasive bowel resection needs more research.

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Stratification to Neoadjuvant Radiotherapy in Rectal Cancer by Regimen and Transcriptional Signatures (2024)

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Type of publication:
Journal article

Author(s):
Mahmood U; Blake A; Rathee S; Samuel L; Murray G; Sebag-Montefiore D; *Gollins S; West NP; Begum R; Bach SP; Richman SD; Quirke P; Redmond KL; Salto-Tellez M; Koelzer VH; Leedham SJ; Tomlinson I; Dunne PD; Buffa FM; Maughan TS; Domingo E

Citation:
Cancer Research Communications. 4(7):1765-1776, 2024 Jul 01.

Abstract:
Response to neoadjuvant radiotherapy (RT) in rectal cancer has been associated with immune and stromal features that are captured by transcriptional signatures. However, how such associations perform across different chemoradiotherapy regimens and within individual consensus molecular subtypes (CMS) and how they affect survival remain unclear. In this study, gene expression and clinical data of pretreatment biopsies from nine cohorts of primary rectal tumors were combined (N = 826). Exploratory analyses were done with transcriptomic signatures for the endpoint of pathologic complete response (pCR), considering treatment regimen or CMS subtype. Relevant findings were tested for overall survival and recurrence-free survival. Immune and stromal signatures were strongly associated with pCR and lack of pCR, respectively, in RT and capecitabine (Cap)/5-fluorouracil (5FU)-treated patients (N = 387), in which the radiosensitivity signature (RSS) showed the strongest association. Upon addition of oxaliplatin (Ox; N = 123), stromal signatures switched direction and showed higher chances to achieve pCR than without Ox (p for interaction 0.02). Among Cap/5FU patients, most signatures performed similarly across CMS subtypes, except cytotoxic lymphocytes that were associated with pCR in CMS1 and CMS4 cases compared with other CMS subtypes (p for interaction 0.04). The only variables associated with survival were pCR and RSS. Although the frequency of pCR across different chemoradiation regimens is relatively similar, our data suggest that response rates may differ depending on the biological landscape of rectal cancer. Response to neoadjuvant RT in stroma-rich tumors may potentially be improved by the addition of Ox. RSS in preoperative biopsies provides predictive information for response specifically to neoadjuvant RT with 5FU. SIGNIFICANCE: Rectal cancers with stromal features may respond better to RT and 5FU/Cap with the addition of Ox. Within patients not treated with Ox, high levels of cytotoxic lymphocytes associate with response only in immune and stromal tumors. Our analyses provide biological insights about the outcome by different radiotherapy regimens in rectal cancer.

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Global 30-day morbidity and mortality of surgery for perforated peptic ulcer: GRACE study (2024)

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Type of publication:
Journal article

Author(s):
Abouelazayem, Mohamed; Jain, Rajesh; Wilson, Michael S J; Martinino, Alessandro; Balasubaramaniam, Vignesh; Biffl, Walter; Coccolini, Federico; *Riera, Manel; Wadhawan, Himanshu; Wazir, Ishaan; Abderaouf, Bettahar; Abramov, Daniil; Abu Jayyab, Mustafa A; Al-Shami, Khayry; Alfarwan, Ahmad; Alhajami, Faris M; Alkaseek, Akram; Alozairi, Ous; Ammar, Ahmed Siddique; Atar, Burak; Baatarjav, Gan-Erdene; Bains, Lovenish; Bakri, Ashraf; Bayramov, Nuru; Bhojwani, Rajesh; Brachini, Gioia; Calini, Giacomo; Campanelli, Michela; Cheng, Shi Yu; Choudhary, Charan Singh; Chowdhury, Sharfuddin; Colak, Elif; Das, Jayanta Kumar; Dawani, Surrendar; Donmez, Turgut; Elzayat, Ibrahim; Erdene, Sarnai; Faizi, Tashaba Qaiser; Frountzas, Maximos; Gafsi, Besma; Gentileschi, Paolo; Guler, Mert; Gupta, Gaurav; Harkati, Nour Elhouda; Harris, Matthew; Hasan, Doaa M; Irowa, Omorodion Omoruyi; Jafferi, Salman; Jain, Sumita Agarwal; Jun Han, Lai; Kandiboyina, Satyanarayana Murthy; Karabulut, Mehmetu; Khamees, Almu'atasim; Khan, Shahzeb; Khan, Madiha Masood; Khaw, Cheng Jing; Kisielewski, Michal; Klib, Mohamad; Kosir, Jurij A; Krawczyk, Wiktor Jan; Lisi, Giorgio; Makama, Jerry Godfrey; Maqbool, Baila; Marques, Claudia Neves; Meric, Serhat; Mietla, Mateusz Przemyslaw; Ads, Alaa Mohamed; Muhumuza, Joshua; Mulita, Francesk; Mustafayeva, Matanat; Omar, Mohammed A; Omarov, Taryel; Pathak, Akshant Anil; Paul, Ratnadeep; Pavone, Giovanna; Podda, Mauro; Raja Ram, Novinth Kumar; Rauf, Fatima; Rauf, Sidra; Safy, Ahmed Mohamed; Sandag, Erdene; Sanli, Ahmet Necati; Siddiqui, Adeela Z; Sotiropoulou, Maria; Talib, Vikash; Tatar, Cihad; Thota, Anuroop; Tokocin, Merve; Tolat, Aditya; Uchikov, Petar Angelov; Valenzuela, Jose I; Venkatappa, Sunil Kumar; Verras, Georgios-Ioannis; Vlahovic, Ivan; Zreeg, Dafer Abdulhakim S; Cardoso, Victor Roth; Gkoutos, Georgios V; Singhal, Rishi; Mahawar, Kamal.

Citation:
Surgical Endoscopy. 2024 Jun 17.

Abstract:
BACKGROUND: There is little international data on morbidity and mortality of surgery for perforated peptic ulcer (PPU). This study aimed to understand the global 30-day morbidity and mortality of patients
undergoing surgery for PPU and to identify variables associated with these. METHOD: We performed an international study of adults (>= 18 years) who underwent surgery for PPU from 1st January 2022 to 30th June 2022. Patients who were treated conservatively or had an underlying gastric cancer were excluded. Patients were divided into subgroups according to age (<= 50 and > 50 years) and time from onset of symptoms to hospital presentation (<= 24 and > 24 h). Univariate and Multivariate analyses were carried out to identify factors associated with higher 30-day morbidity and mortality. RESULTS: 1874 patients from 159 centres across 52 countries were included. 78.3% (n = 1467) of the patients were males and the median (IQR) age was 49 years (25). Thirty-day morbidity and mortality were 48.5% (n = 910) and 9.3% (n = 174) respectively. Median (IQR) hospital stay was 7 (5) days. Open surgery was performed in 80% (n = 1505) of the cohort. Age > 50 years [(OR = 1.7, 95% CI 1.4-2), (OR = 4.7, 95% CI 3.1-7.6)], female
gender [(OR = 1.8, 95% CI 1.4-2.3), (OR = 1.9, 95% CI 1.3-2.9)], shock on admission [(OR = 2.1, 95% CI 1.7-2.7), (OR = 4.8, 95% CI 3.2-7.1)], and acute kidney injury [(OR = 2.5, 95% CI 1.9-3.2), (OR = 3.9), 95% CI
2.7-5.6)] were associated with both 30-day morbidity and mortality. Delayed presentation was associated with 30-day morbidity [OR = 1.3, 95% CI 1.1-1.6], but not mortality. CONCLUSIONS: This study showed that surgery for PPU was associated with high 30-day morbidity and mortality rate. Age, female gender, and signs of shock at presentation were associated with both 30-day morbidity and mortality.

Association of day-case rates with post COVID-19 recovery of elective laparoscopic cholecystectomy activity across England (2024)

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Type of publication:
Journal article

Author(s):
Ayyaz, F M; Joyner, J; *Cheetham, M; Briggs, Twr; Gray, W K.

Citation:
Annals of the Royal College of Surgeons of England. 2024 Apr 02.

Abstract:
INTRODUCTION: The aim of this study was to investigate the safety of day-case laparoscopic cholecystectomy, and the association between day-case rates and, post the COVID-19 pandemic, recovery of activity to prepandemic levels for integrated care boards (ICBs) in England. METHODS: This was a retrospective observational study of the Hospital Episodes Statistics (HES) data set. Elective laparoscopic
cholecystectomies for the period 1 January 2019 to 31 December 2022 were identified. Activity levels for 2022 were compared with those for the whole of 2019 (baseline). Day-case activity was identified where the length of stay recorded in the HES was zero days. RESULTS: Data were available for 184,252 patients across the 42 ICBs in England, of which 120,408 (65.3%) were day-case procedures. By December
2022, activity levels for the whole of England had returned to 88.2% of prepandemic levels. The South West region stood out as having recovered activity levels to the greatest extent, with activity at 97.3% of
prepandemic levels during 2022. The South West also had the highest postpandemic day-case rate at 74.9% of all patients seen as a day-case during 2022; this compares with an England average of 65.3%. At an ICB level, there was a significant correlation between day-case rates and postpandemic activity levels (r = 0.362, p = 0.019). There was no strong or consistent evidence that day-case surgery had poorer patient outcomes than inpatient surgery. CONCLUSIONS: Recovery of elective laparoscopic cholecystectomy activity has been better in South West England than in other regions. Increasing day-case rates may be important if ICBs in other regions are to increase activity levels up to and beyond prepandemic levels.

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Coeliac disease (2024)

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Type of publication:
Journal article

Author(s):
*Butterworth J.; Los L.

Citation:
Medicine (United Kingdom). 52(3) (pp 174-180), 2024. Date of Publication: March 2024.

Abstract:
Coeliac disease (CD) is a common, chronic, immune-mediated small bowel enteropathy resulting from gluten exposure in genetically susceptible individuals. Considerable clinical and immunopathological heterogeneity is seen in newly diagnosed patients, and the diagnosis is not always straightforward even for experienced physicians. Population screening using tissue transglutaminase-2 has revealed a higher prevalence of seropositivity than previously appreciated. There is a wide differential diagnosis for mucosal villous atrophy, crypt hyperplasia and increased intraepithelial lymphocyte concentrations. Life-long adherence to a gluten-free diet is currently the only recommended treatment for CD, although many newer approaches are being explored. CD is rightly described as a multisystem disorder and is associated with other gastrointestinal- and non-gastrointestinal-related disorders, numerous complications and possibly reduced survival. The landscape has recently expanded with the identification that some patients with symptoms suggestive of CD but without the mucosal changes seem to respond to a gluten-free diet. This group are currently labelled as having non-coeliac gluten sensitivity. Controversy exists over whether this is a separate disease entity. This review briefly discusses the important clinical, immunological and therapeutic aspects of CD.

Baseline Expression of Immune Gene Modules in Blood is Associated With Primary Response to Anti-TNF Therapy in Crohn's Disease Patients (2024)

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Type of publication:
Journal article

Author(s):
Journal of Crohn's and Colitis. 18(3) (pp 431-445), 2024. Date of Publication: 01 Mar 2024

Citation:
Reppell M.; Smaoui N.; Waring J.F.; Pivorunas V.; Guay H.; Lin S.; Chanchlani N.; Bewshea C.; Goodhand J.R.; Kennedy N.A.; Anderson C.A.; Patel V.; Mazhar Z.; Saich R.; Colleypriest B.; Tham T.C.; Iqbal T.H.; Kaushik V.; Murugesan S.; Singhi S.; Weaver S.; Preston C.; Butt A.; Smith M.; Basude D.; Beale A.; Langlands S.; Direkze N.; Parkes M.; Torrente F.; De La Revella Negro J.; MacDonald C.E.; Evans S.M.; Gunasekera A.V.J.; Thakur A.; Elphick D.; Shenoy A.; Nwokolo C.U.; Dhar A.; Cole A.T.; Agrawal A.; Bridger S.; Doherty J.; Cooper S.C.; de Silva S.; Mowat C.; Mayhead P.; Lees C.; Jones G.; Hart J.W.; Gaya D.R.; Russell R.K.; Gervais L.; Dunckley P.; Mahmood T.; Banim P.J.R.; Sonwalkar S.; Ghosh D.; Phillips R.H.; Azaz A.; Sebastian S.; Shenderey R.; Armstrong L.; Bell C.; Hariraj R.; Matthews H.; Jafferbhoy H.; Selinger C.P.; Zamvar V.; De Caestecker J.S.; Willmott A.; Miller R.; Babu P.S.; Tzivinikos C.; Bloom S.L.; Chung-Faye G.; Croft N.M.; Fell J.M.E.; Harbord M.; Hart A.; Hope B.; Irving P.M.; Lindsay J.O.; Mawdsley J.E.; McNair A.; Monahan K.J.; Murray C.D.; Orchard T.; Paul T.; Pollok R.; Shah N.; Bouri S.; Johnson M.W.; Modi A.; Kabiru K.D.; Baburajan B.K.; Bhaduri B.; Fagbemi A.A.; Levison S.; Limdi J.K.; Watts G.; Foley S.; Ramadas A.; MacFaul G.; Mansfield J.; Grellier L.; Morris M.-A.; Tremelling M.; Hawkey C.; Kirkham S.; Charlton C.P.J.; Rodrigues A.; Simmons A.; Lewis S.J.; Snook J.; Tighe M.; Goggin P.M.; De Silva A.N.; Lal S.; Smith M.S.; Panter S.; Cummings F.; Dharmisari S.; Carter M.; Watts D.; Mahmood Z.; McLain B.; Sen S.; Pigott A.J.; Hobday D.; Wesley E.; Johnston R.; Edwards C.; Beckly J.; Vani D.; Ramakrishnan S.; Chaudhary R.; Trudgill N.J.; Cooney R.; Bell A.; Prasad N.; Gordon J.N.; Brookes M.J.; Li A.; Gore S.; Bai B.Y.H.; Ahmad T.;

Abstract:
Background and Aims: Anti-tumour necrosis factor [anti-TNF] therapy is widely used for the treatment of inflammatory bowel disease, yet many patients are primary non-responders, failing to respond to induction therapy. We aimed to identify blood gene expression differences between primary responders and primary non-responders to anti-TNF monoclonal antibodies [infliximab and adalimumab], and to predict response status from blood gene expression and clinical data. Method(s): The Personalised Anti-TNF Therapy in Crohn's Disease [PANTS] study is a UK-wide prospective observational cohort study of anti-TNF therapy outcome in anti-TNF-naive Crohn's disease patients [ClinicalTrials.gov identifier: NCT03088449]. Blood gene expression in 324 unique patients was measured by RNA-sequencing at baseline [week 0], and at weeks 14, 30, and 54 after treatment initiation [total sample size = 814]. Result(s): After adjusting for clinical covariates and estimated blood cell composition, baseline expression of major histocompatibility complex, antigen presentation, myeloid cell enriched receptor, and other innate immune gene modules was significantly higher in anti-TNF responders vs non-responders. Expression changes from baseline to week 14 were generally of consistent direction but greater magnitude [i.e. amplified] in responders, but interferon-related genes were upregulated uniquely in non-responders. Expression differences between responders and non-responders observed at week 14 were maintained at weeks 30 and 54. Prediction of response status from baseline clinical data, cell composition, and module expression was poor. Conclusion(s): Baseline gene module expression was associated with primary response to anti-TNF therapy in PANTS patients. However, these baseline expression differences did not predict response with sufficient sensitivity for clinical use.

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Efficacy of atypical antipsychotics in the treatment of fecal incontinence in children and adolescents: a randomized clinical trial (2024)

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Type of publication:
Randomised controlled trial

Author(s):
Zahed, Ghazal; Fatahi, Somaye; Tabatabaee, Leila; Imanzadeh, Negar; *Seraj, Shaikh Sanjid; Wolters, Benjamin Hernandez; Hosseini, Amirhossein

Citation:
BMC Pediatrics. 24(1):7, 2024 Jan 03.

Abstract:
OBJECTIVES: Functional retentive overflow incontinence (retentive FI) is the most common cause of fecal soiling in children. Based on the clinical experiences, the treatment of retentive FI in patients with comorbid psychiatric disorders was accelerated when Risperidone was used as treatment for their psychiatric comorbidities; therefore, this study was conducted to evaluate the effect of risperidone in the treatment of retentive FI in children and adolescents. METHODS: In this double-blind, randomized, placebo-controlled trial, 140 patients aged 4-16 years eligible for the study were randomized into two groups, receiving either 0.25-0.5 mg of Risperidone syrup (n = 70) or maltodextrin syrup (placebo group, n = 70) every 12 h daily for 12 weeks. Sociodemographic data, including age, sex, weight, height, BMI, BMI z-score, and socioeconomic status, was recorded, and the number of nocturnal FI, diurnal FI, and painful defecations was measured. RESULTS: 136 participants (69 on Risperidone and 67 on placebo) were included in the study. Mean age of participants in the intervention and placebo groups were 7.2 +/- 2.4 years and 8.0 +/- 3.1 years, respectively. The mean number of nocturnal FI (Ptrend=0.39) and diurnal FI (Ptrend=0.48) in patients without psychiatric comorbidities, and the number of painful defecations for participants with and without psychiatric comorbidities (P = 0.49, P = 0.47, respectively) were not significantly different between the groups, but a significant effect was observed in diurnal FI after Risperidone treatment in patients with psychiatric comorbidities (P < 0.001). CONCLUSION: Risperidone, when used along with other non-pharmacological interventions, may be helpful in treating FI in pediatric patients with psychiatric comorbidities.

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The Short- and Long-Term Safety and Efficacy Profile of Subtotal Cholecystectomy: A Single-Centre, Long-Term, Follow-Up Study (2023)

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Type of publication:
Journal article

Author(s):
*Bodla, Ahmed Salman; *Rashid, Muhammad Umair; *Hassan, Maleeha; *Rehman, Saad; *Kirby, George.

Citation:
Cureus. 15(8):e44334, 2023 Aug. [epub ahead of print]

Abstract:
Background Subtotal cholecystectomy (STC) has been reported as an effective method to remove the gallbladder if the hepatocystic triangle anatomy is unfavourable. However, the evidence regarding its long-term outcomes from the United Kingdom (UK) is lacking. This study aimed to assess its short and long-term outcomes with a minimum of one-year follow-up. Methodology We retrospectively analysed all elective and emergency STCs performed in a single UK NHS Trust between 2014 and 2020. Relevant data were collected using electronic patient records and questionnaire-based, long-term, telephonic follow-up (median follow-up of 3.7 years). Outcomes examined were immediate/short-term complications (biliary injury, bile leak, return-to-theatre) and long-term problems (recurrent symptoms, choledocholithiasis, cholangitis/pancreatitis). Results There were a total of 50 STC cases (58% females) out of 4,341 cholecystectomies performed (1.15%), with the median age, body mass index, and length of stay being 69.5 years, 29 kg/m2 and eight days, respectively. Twenty-eight (56%) were emergency. No patient endured bile duct injury. Seven (14%) patients had postoperative bile leak which was significantly more common when Hartmann's pouch was left open (33% vs. 8%; p = 0.03). No bile duct injury was reported. Most were managed conservatively (endoscopic retrograde cholangiopancreatography + stent: four; radiological drainage: one; no intervention: one). Only one patient required laparoscopic lavage and drainage. The true incidence of developing choledocholithiasis over the long term was 4/50 (8%) in our study. The median interval between STC and the diagnosis of postoperative choledocholithiasis was 15.9 months. All four patients had undergone type 1 STC (where the remnant of Hartmann's pouch was closed with sutures); however, subsequent cross-sectional imaging (magnetic resonance cholangiopancreatography or computed tomography) showed that the gallbladder remnant was visible in only two of these four patients. Conclusions STC is a safe option in difficult situations and prevents bile duct injury. Although the risk of bile leak can be reduced by closing Hartmann's pouch remnant, this may slightly increase the risk of subsequent stone formation. Infrequent occurrence of recurrent gallstone-related symptoms or complications favours its use

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Patients' frailty and co-morbidities do not affect short-term mortality following emergency colorectal cancer surgery (2023)

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Type of publication:
Journal article

Author(s):
*Mak, Richard; Deckmann, Nico; Collins, Danielle; Maeda, Yasuko.

Citation:
The Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh & Ireland. February 2024, 22(1):52-59

Abstract:
AIM: To investigate the effects of frailty and co-morbidities on short and medium-term outcome following emergency colorectal cancer surgery. METHODS: Data of patients who underwent emergency colorectal cancer operations between January 2013 and December 2016 were reviewed retrospectively. Collected data included demographic and operative variables, clinical frailty scale (CFS), Charlson comorbidity index (CCI) and cause of death with minimum 3 years follow-up. RESULTS: Three-hundred and six patients (median age 72, range 18-100 years) underwent emergency colorectal cancer surgery; Some 74 (24.2%) patients had metastatic cancer at the time of emergency surgery, 77 (25.2%) were frail (CFS >=4), while 118 (38.6%) were comorbid (CCI of >=8). Thirty-day mortality was 4.2% (13 patients) and a further 12 patients died within 90 days (8.2%). By 1 year 73 (23.9%) patients had died, and by 3 years 151 (49.3%) patients died. Frailty did not impact 30-day mortality (6.5% vs 3.5%, p = 0.26) but frail patients (CFS >=4) had a higher mortality rate at 90 days (16.9% vs 5.2%, p < 0.05), 1 year (37.7% vs 19.2%, p < 0.05) and 3 years (61.0% vs 45.4%, p < 0.05). Similarly, higher comorbidity (CCI >=8) did not impact 30-day mortality (5.9% vs 3.2%, p = 0.25), but they had a higher mortality rate at 90 days (14.4% vs 4.3%, p < 0.05), 1 year (40.7% vs 13.3%, p < 0.05), and 3 years (76.3% vs 32.4%, p < 0.05). CONCLUSION: Thirty-day mortality after emergency colorectal cancer surgery in frail and comorbid patients are similar to that of the general population.