Emergency surgery for complicated colorectal carcinoma: a comparison of older and younger patients

The outcomes after emergency surgery for complicated colorectal cancer of 54 patients >70 years of age (group 1) and 53 patients < or =70 years of age (group 2) treated between 1991 and 2002 were compared. Forty-two patients had obstructions in group 1 and 41 patients had obstructions in group 2. Twelve patients had perforations in each group. Significantly higher ASA grading and APACHE II scores were seen in group 1. The overall and major morbidity and mortality rates in groups 1 and 2 were 81.5% and 58.5% (P = 0.009), 42.6% and 24.6% (P = 0.04), and 27.8% and 1.9% (P = 0.000), respectively. It was concluded that the outcome in older patients who underwent emergency surgery for complicated colorectal carcinoma was poor compared with that of younger patients. Careful preoperative assessment of the patient's general condition and intensive treatment after surgery in those with a poor physical status are recommended.