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[In Process Citation]

Kriwanek1, Armbruster, Beckerhinn

  • 1Chirurgische Abteilung, Krankenanstalt Rudolfstiftung, Wien.

Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|March 9, 1999
PubMed
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Radical tumor surgery for complicated colorectal cancers shows high mortality but similar long-term outcomes to uncomplicated cases when patients survive the acute stage. Tumor stage impacts long-term results, not the complication itself.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Colorectal Surgery

Background:

  • Colorectal cancer complications like obstruction and perforation necessitate emergency surgery.
  • Assessing outcomes of radical tumor surgery in these emergency settings is crucial.

Purpose of the Study:

  • To investigate the postoperative and long-term results of radical tumor surgery in patients with complicated colorectal cancers (bowel obstruction or perforation).
  • To compare outcomes between complicated and uncomplicated colorectal cancer cases.

Main Methods:

  • Retrospective analysis of 1071 patients treated for large bowel cancer between 1986 and 1997.
  • Specific focus on 126 patients operated on for bowel obstruction or perforation.
  • Evaluation of postoperative mortality, survival rates, and long-term results based on complication type, preoperative organ dysfunction, peritonitis, tumor stage, and comorbidities.

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Main Results:

  • Postoperative mortality was significantly higher in complicated cases (19% obstruction, 38% perforation) compared to uncomplicated cases (6%).
  • Preoperative organ dysfunction was a key determinant of survival in both complications.
  • Mortality after perforation was linked to peritonitis and tumor stage; cardiac comorbidity increased risk after obstruction.
  • Long-term results were primarily dependent on tumor stage, not the presence of complications.

Conclusions:

  • Radical tumor surgery in emergency settings for complicated colorectal cancer is a viable approach.
  • Patients surviving the acute phase of complicated colorectal cancer have long-term outcomes comparable to those with uncomplicated carcinomas.
  • Tumor stage remains the most critical factor for long-term prognosis, irrespective of acute complications.