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Does emergency surgery affect resectability of colorectal cancer?
T E Pavlidis1, G Marakis, K Ballas
1Second Propedeutical Department of Surgery, Medical School, Aristotle. University of Thessaloniki, Hippocration Hospital, Konstantinoupoleos 49, 546 42, Thessaloniki, Greece. pavlidth@med.auth.gr
Acta Chirurgica Belgica
|June 18, 2008
Summary
Emergency colorectal cancer surgery has lower resectability and higher morbidity and mortality than elective surgery. These outcomes are acceptable, especially when considering the emergency context for colorectal carcinoma patients.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Colorectal Surgery
Background:
- Emergency surgery for colorectal cancer is frequently necessitated by bowel obstruction.
- This emergency surgical approach is associated with increased patient morbidity and mortality.
- The impact of emergency surgery on disease stage and resectability remains unclear.
Purpose of the Study:
- To investigate the relationship between emergency surgery for colorectal cancer and disease parameters.
- To compare outcomes of emergency versus elective colorectal cancer surgery.
- To analyze the influence of age on emergency colorectal cancer surgery outcomes.
Main Methods:
- Retrospective analysis of 121 emergency colorectal cancer surgeries over 24 years.
- Comparison with elective surgery cases (total 1009 patients).
- Stratification of emergency cases by age (>= 70 and < 70 years).
Main Results:
- Lower rates of macroscopic disease clearance (57.8% vs 72%) and resectability (75% vs 90%) in emergency cases.
- No significant difference in tumor differentiation or invasion depth between emergency and elective groups.
- Higher morbidity (20%) and 30-day mortality (5.8%) in emergency surgery, particularly in patients aged 70 and older.
Conclusions:
- Emergency surgery for colorectal carcinoma is linked to reduced resectability.
- Postoperative morbidity and mortality are higher in emergency settings but considered acceptable.
- Elective surgical management offers superior resectability and lower complication rates for colorectal cancer.
