Management of Perforated Colon Cancers

Abstract

It is known that emergency surgery for colon cancer is associated with high morbidity and mortality. We retrospectively evaluated in this study our colon cancer patients admitted with perforation. The total 223 patients who had colon cancer, 74 (33%) underwent emergent colon surgery and 34 (15%) of them had perforation. Median age was 60.65±10.06 years (range:39-79 years) and 12 patients were female (35%). The most common tumor localization was in sigmoid colon (41%). Perforation site was proximal to the tumor in 26 cases (76.5%) and at the tumor site in 8 (23.5%). Peritonitis was present in 28 patients (82%). One of the major complications was anastomotic dehiscence (6 patients, 17.6%). The mortality rate was 29.4% (10 patients) and the morbidity rate was 47.1% (16 patients). The mortality of perforated colon cancer cases is high. Factors associated with mortality are left sided colon tumors (p=0.006), ASA score > 2 (p=0.01), the presence of liver metastasis (p=0.005) and the presence of >25 index according to Mannheim peritonitis index (p=0.002)

Keywords

• Colon cancer, perforation, management

Management of Perforated Colon Cancers

Öz

Kolon kanseri için acil cerrahi yüksek morbidite ve mortalite ile ilişkili olduğu bilinmektedir. Biz geriye dönük olarak perforasyon ile başvuran kolon kanseri hastalar değerlendirilmiştir. Kolon kanserli toplam 223 hasta çalışmaya alındı, bunların 74'üne (%33) acil kolon cerrahisi uygulandı ve bunların 34 (%15)'ünde perforasyon mevcut idi. Ortalama yaş 60.65±10.06 yıl (39-79 yaş) idi ve 12 hasta kadın (%35) idi.En sık tümör lokalizasyonu sigmoid kolonda (%41) idi. Perforasyon yeri 26 hastada (%76.5) tümörün yakınında ve 8 (% 23.5)'inde tümör sahasında idi. Peritonit 28 hastada (% 82) mevcuttu. Önemli komplikasyonlarından biri anastomoz yarılması (6 hasta, %17.6) idi. Mortalite oranı %29.4 (10 hasta) ve morbidite oranı %47.1 (16 hasta) idi. Perfore kolon kanseri vakalarının mortalitesi yüksek idi. Mortalite ile ilişkili faktörler sol taraflı kolon tümörleri (p=0.006), ASA skoru >2 (p=0.01), karaciğer metastazı varlığı (p = 0.005) ve Mannheim peritonit indeksine göre >25 (p = 0.002) idi

Anahtar Kelimeler

• Kolon kanseri, perforasyon, tedavi

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