EMERGENCY SURGERY FOR COMPLICATED COLORECTAL CANCER. RETROSPECTIVE STUDY

Abstract

Introduction: Emergency surgery for the complications of colorectal cancer poses a significant surgical problem with published mortality rates as hight as 25% to 30%. We reviewed the results of the analysis and quantification of the influence of complications on the outcome of the patients who underwent emergency colectomy for colorectal cancer.

Materials and methods: Retrospective study of the clinical features from, a series of 63 patients operated on from 1991 to 1997 (12% of all colorectal cancer operations in the same period). The correlations between complications and cancer stages were estimated by the KW (ANOVA method).

Results: Fifty-three patients undewent colorectal resection for intestinal occlusion (84%), 5 for perforation (8%) and 5 for lower gastrointestinal bleeding (8%). When the cancer complications were correlated to the different cancer stage at operation, the complications rate were 32%, 32%, and 36% in the stage II, stage III, and stage IV, respectively. This data was statistically significant: (KW=58, p=0,0001). The overrall mortality rate was 8% (5 patients) and the total postoperative morbility rate was 32% (21 patients). The overral 5-year, 3-year, and 1-year survival was 47%, 48%, and 76% respectively.

Conclusions: Emergency surgery for complicated colorectal cancer can be performed safely with low postoperative morbility and mortality rate and can be advocated to realize both short and long term survival rates comparable to elective surgery; the KW test supports the hypotesis that the onset of a complication in the natural history of colorectal cancer doesn’t correlate with the stage of desease.