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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2005 October;18(5):307-12
Has the location of colorectal tumors changed? Considerations on a direct surgical experience during the last decade
Basilico V., Griffa B., Capriata G.
Aim. The Authors claim that their direct surgical experience during the past 10 years shows that colorectal carcinoma (CCR) has increasingly been found to the right colon, contrary to data traditionally found in medical textbooks. They therefore decided to accurately analyse all the operations performed for colorectal carcinoma during the last ten years at the first surgical department of Valduce Hospital in Como, Italy, to try confirmation or denial to this claim. The data obtained from this study are not intended to be all-inclusive, but rather want to set the basis for more comprehensive studies at a later date.
Methods. From january 1, 1995 to december 31, 2004, 859 (for a total of 867 cases) patients, affected with colo-rectal carcinoma, were operated on in the first surgical department of the above-mentioned hospital. The decade of observation was divided in two subsequent five-year periods: in the first, from 1995 to 1999, 353 operations were performed, while in the period 2000 to 2004, there were 514 cases. For the sake of clarity, the neoplasms localized to the right colon include the cecum, the ascending colon and the hepatic flexure; those localized to left colon include the splenic flexure and the descending colon. The remaining locations are the transverse colon, the sigmoid colon with the recto-sigmoid passage and the rectum.
Results. The overall percent data, that refer to the entire decade, were subdivided as follows: right colon 33,6%; transverse colon 5,6%; left colon 9,8%; sigmoid colon 25,8%; rectum, 25,2%. The following comments can be made: neoplasms of the right colon represent the most frequent location of CCR and comprise about 1/3 of all cases; the comprehensive percentage of all cases localized to sigmoid colon and rectum is 50%; if the two five-year periods are compared in detail, an increase of CCR cases of the right colon is evident: from 30,6% in 1995-1999 to 35,6% in 2000-2004, accompanied by a decrease in the sigmoid colon and rectum, from 53,5% in 1995-1999 to 49,2% in 2000-2004.
Conclusion. The Authors hope that the above considerations will encourage other institutions to undertake clinical studies with lager number of patients which may, in the end, prove conclusive evidence of the present study.