[Urgent surgery in colon carcinoma]

Area of Science:

• Oncology
• Surgical Oncology
• Gastrointestinal Surgery

Context:

• Colon carcinoma necessitates surgical intervention in approximately 10% of cases under emergency conditions due to severe preoperative complications.
• Urgent surgeries for colon carcinoma are frequently associated with advanced tumor stages and poorer patient health status.

Purpose:

• To analyze postoperative morbidity and long-term prognosis in patients undergoing elective versus urgent surgery for colon carcinoma.
• To identify urgent surgery as an independent prognostic factor for distant metastasis and cancer-related survival.

Summary:

• Urgent surgery for colon carcinoma occurred in 11% of cases, primarily for bowel obstruction (73%) or perforation (20%).
• Emergency patients were older, in worse general condition, and experienced higher rates of postoperative complications (28.8% vs. 19.8%) and mortality (10.1% vs. 4.0%) compared to elective surgery patients.
• Urgent surgery independently predicted increased risk of distant metastasis (RR 1.8) and reduced cancer-related survival (RR 1.6).

Impact:

• Findings underscore the challenges of emergency colon carcinoma surgery, often in elderly patients with advanced disease.
• Highlights the critical need for experienced surgical teams and adequate emergency medical resources for these high-risk interventions.
• Results emphasize the significant negative impact of urgent surgical intervention on patient outcomes and survival in colon carcinoma cases.