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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2008 October;21(5):251-4
Emergency surgery in colorectal cancer: a review of cases
Ammenti M., Deregibus P. G., Poncina F., Tribocco M.
Ospedale “Santo Spirito” Casale Monferrato, Alessandria, Italia
Aim. Colorectal cancer (CRC) continues to have a strong social impact. In 30% of cases, CRC begins with a complication that is generally occlusion (about 80%) and in the remainder perforation of the site of the tumour (20%). The purpose of the present study is to analyse the characteristics of patients operated on for CRC in emergency situations and compare results with those cases in which surgery was elective.
Methods. Eighty-five consecutive patients operated on for complicated CRC in the period between 2001 and 2005 were analysed. Of the 85 emergency patients the data regarding age, gender, associated pathologies, type of complication (occlusion and/or perforation), site of the cancer, type of operation, staging, postoperative complications, mortality and survival were collected. Finally, these patients were compared with 218 operated on electively for CRC in the same period.
Results. In our series the percentage of patients subjected to potentially curative operations in complicated CRCs was lower than the number of elective patients (67.06% against 77.98%, P<0.05). Postoperative morbility and mortality rates tend to be higher in patients with complicated CRC compared with elective patients (respectively 18.82% and 2.35% against 16.51% and 1.83%). One year and 3 year survival overall and cancer-related in patients with complicated CRC subjected to potentially curative operation shows highly favourable results (respectively 96.43%, 71.43% and 76.92%).
Conclusion. Curative surgery can be carried out in emergency conditions, if possible, with acceptable levels of morbility and mortality, comparable with those of patients operated on electively. Finally, even the long-term survival of patients with complicated CRC subjected to emergency surgery is close to that of elective patients if the operation is carried out according to criteria of oncological radicality.