Obstructive colorectal carcinoma. Principles and technique in 134 cases

Area of Science:

• Oncology
• Gastroenterology
• Surgical Oncology

Background:

• Colorectal carcinoma is a major health concern.
• Intestinal obstruction presents a significant challenge in managing colorectal cancer.
• Understanding the impact of obstruction on treatment and outcomes is vital.

Purpose of the Study:

• To determine the influence of intestinal obstruction on the therapy and prognosis of colorectal carcinoma.
• To compare outcomes between obstructed and non-obstructed colorectal cancer patients.

Main Methods:

• Retrospective analysis of 1756 colorectal carcinoma patients diagnosed between 1966 and 1990.
• Evaluation of obstruction incidence, operative mortality, curative resection rates, and survival data.

Main Results:

• Obstruction occurred in 8% of patients (n=134), with 3% experiencing perforation.
• Operative mortality was 30% for obstructed cases versus 7% for elective surgery.
• Curative resections were possible in 34% of obstructed cases, compared to 75% of non-obstructed cases.
• 5-year survival dropped from 51% to 23% in obstructed patients.
• Primary resection is beneficial for right colon obstructions; its advantage for left-sided lesions is less clear.
• One-stage procedures have increased with reduced mortality in recent years.

Conclusions:

• Intestinal obstruction adversely affects colorectal carcinoma prognosis, increasing operative mortality and decreasing survival.
• While tumor location influences surgical strategy, complete malignancy removal during the initial operation is desirable.
• Advancements in surgical procedures have led to reduced mortality for obstructed colorectal cancer.