The outcome of surgical treatment in patients with obstructive colorectal cancer

Abstract

Objectives: Colorectal cancer obstructions are responsible for about 85% of colonic emergencies. The aim of this study was to investigate the results of urgent surgical intervention that applied in acute colonic obstructions related to cancer. Methods: In this study, 86 cases presenting with acute colonic obstruction who were operated with the diagnosis of colonic tumor between January 2010 and December 2010 were assessed retrospectively. Age, gender, symptoms on presentation, presence of concomitant disease, surgical methods applied, complication and mortality rates were recorded. Results: Fifty of the cases were male, 36 were female. The mean age was 63.6 years. Twenty cases had undergone emergency colonoscopic examination at diagnosis and an obstructive lesion had been observed. The surgical operations performed were right hemicolectomy in 18, sigmoid resection in 34, left hemicolectomy in 10, abdomino-perineal resection in 2, subtotal colectomy in 4, transverse colectomy in two. Primary anastomosis was performed in thirty-four cases. Mortality was observed in 12 cases. Conclusions: In selected cases of left colon cancers with obstruction, resection and primary anastomosis is generally possible. Those over 70, presence of co-morbidities, albumin level under 3 g/dl, ASA score 3 and higher, blood loss of more than 500 ml, and preoperative blood transfusion were related to the high postoperative morbidity.

Keywords

• Colorectal cancer, obstruction, surgical treatment, outcome.

Obstrüktif kolorektal kanserli hastalarda cerrahi tedavi sonuçları

Abstract

Amaç: Kolorektal kanserlere bağlı obstrüksiyonlar kolonik acillerin yaklaşık %85\'inden sorumludur. Bu çalışmanın amacı, kansere bağlı gelişen akut kolorektal obstrüksiyonlarda uygulanacak cerrahi girişimin sonuçlarını incelemektir. Yöntemler: Bu çalışmada Ocak 2000-Aralık 2010 tarihleri arasında kliniğimize akut kolon obstrüksiyonu ile başvuran ve kolon tümörü tanısı ile opere edilen 86 olgu retrospektif olarak değerlendirildi. Yaş, cins, başvuru anındaki semptomlar, ek hastalığının olup olmaması, uygulanan cerrahi yöntemler, komplikasyon ve mortalite oranları tespit edildi. Bulgular: Olguların 50\'si erkek, 36\'sı kadındı. Ortalama yaş 63,6 yıl idi. Olguların 20\'sinde tanıda acil kolonoskopik değerlendirme yapıldı ve tıkayıcı lezyon gözlendi. Olguların 18\'ine sağ hemikolektomi, 34\'üne sigmoid rezeksiyon, 10\'una sol hemikolektomi, 2\'sine abdomino-perineal rezeksiyon, 4\'üne subtotal kolektomi, 2\'sine transvers kolektomi yapıldı. Primer anastomoz 34 olguya yapıldı. Toplam 12 olguda mortalite görüldü. Sonuç: Obstrüktif sol kolon kanserlerinde seçilmiş vakalarda rezeksiyon ve primer anastomoz genellikle mümkündür. 70 üzeri yaş, komorbiditenin varlığı, albümin değerinin 3 g/dl\'nin altında olması, ASA skorunun 3 ve üzeri olması, 500 ml\'den fazla kan kaybı ve ameliyatta kan verilmesi postoperatif yüksek mortalite ile ilişkili bulundu.

Keywords

• Kolorektal kanser, obstrüksiyon, cerrahi tedavi, sonuç.

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