Emergency surgery for obstructive colorectal cancer
Keywords:
colorectal cancer, acute intestinal obstructionAbstract
Colorectal cancer (CRC) is the third most common form of cancer and the second cause of death in neoplasms. The most common complication is an intestinal obstruction (80%), in 8-35% of cases emergency surgical treatment is required. The aim of the study was to study the incidence of tumor occlusion of the colon and to analyze the early results of emergency surgical treatment. The results of the emergency surgical treatment of 128 patients with obstructive CRC were analyzed. In locations on the right colon, right hemicolectomy was performed in the (14, 15.3%) cases, in 15 (16.4%)- colo/cecostomy, bypass- in 2 (2.1%) patients. For left colon tumors: left hemicolectomy with anastomosis- in 2 (2.1%) patients, Hartmann operation- 39 (42.8%), segmental intestinal resection- 7 (7.6%), recto-sigmoid resection- 3 ( 3.2%), in 9 (9.8%) patients- colostomy. Early postoperative complications and in-hospital mortality were analyzed. The male/female ratio was 1/1.2, with the predominance of people over 60 years old – 75.8% of cases. Obstruction of the left colon (65.9%) predominated over the right (34.1%). A connection was established between the frequency of postoperative complications, the ASA class and comorbidities, which explains the high incidence of early postoperative complications – 70.4% of cases. General complications were more common than surgical ones - 1.9/1. According to Clavien-Dingo, 27 (29.6%) patients had no complications, grade I-11 (12.1%) patients, II 15 (16.5%), III-10 (10.9%), IV -7 (7.7%) and grade V-21 (23.1%) patients. The postoperative evolution of obstructive CRC patients undergoing emergency surgical treatment is characterized by various general and surgical complications, as well as a high in-hospital mortality.
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