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 23 May 2018

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News

Treating obstructive and perforative colorectal carcinoma

Emergency surgery for colorectal carcinoma has high morbidity and mortality rates, and the latest issue of the American Journal of Surgery recommends intensive treatment after surgery in patients with risk factors.

News image

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It is known that emergency surgery for colorectal cancer is associated with high morbidity and mortality.

Dr Avenida de Galicia and colleagues from Spain assessed the presentation, treatment, and outcome of patients with complicated colorectal cancer.

The research team also evaluated risk factors for morbidity and mortality.

Medical records of 107 patients undergoing emergency surgery for obstructing or perforating colorectal cancer from 1991 to 2002 were retrospectively reviewed.

The team recorded information regarding patient and tumor characteristics, treatment, and outcome.

Risk factors were assessed by multivariate analysis.

The researchers found that 78% of patients had complete obstruction and 22% had perforation.

A risk factor for major morbidity was perioperative blood transfusion
American Journal of Surgery

The team noted that overall and major complications occurred in 70% and 34%, respectively.

The researchers reported that the mortality rate was 15%.

Independent risk factors for major morbidity were perioperative blood transfusion and high American Society of Anesthesiologists class.

However, the team noted that risk factors for mortality were older age and high Acute Physiology and Chronic Health Evaluation II (APACHE II) score.

Dr Alvarez's team concludes, “Emergency surgery for complicated colorectal carcinoma carries high rates of morbidity and mortality.”

“To achieve improvements in outcome, intensive treatment after surgery in patients with risk factors is recommended.”

Am J Surg 2005: 190(3): 376-82
18 August 2005

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