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Obstructive colonic cancer

A Papachristodoulou1, G Zografos, C Markopoulos

  • 12nd Propedeutic Surgical Department, Athens University School of Medicine, Greece.

Journal of the Royal College of Surgeons of Edinburgh
|October 1, 1993
PubMed
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Acute colonic obstruction in cancer patients presents a grim prognosis, often linked to advanced disease and delayed treatment. This review highlights high rates of complications, mortality, and poor survival, emphasizing the need for timely intervention.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Clinical Research

Background:

  • Obstructing colon cancer poses significant clinical challenges.
  • A substantial proportion of patients present with metastatic disease at diagnosis.
  • Timely intervention is crucial for improving outcomes in these patients.

Purpose of the Study:

  • To review the clinical outcomes of patients with obstructing colon cancer.
  • To identify factors contributing to the high morbidity and mortality associated with this condition.

Main Methods:

  • Retrospective review of 121 patient records with obstructing colon cancer.
  • Analysis of surgical procedures, complications, operative mortality, and survival rates.
  • Identification of prognostic factors.

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Main Results:

  • One-third of patients had metastatic disease at operation.
  • Common procedures included primary resection and anastomosis (ascending/transverse colon) and Hartmann's procedure (sigmoid/rectum).
  • High rates of wound infection (16.5%), anastomotic leakage (4.9%), operative mortality (14.9%), and a 5-year survival rate of 13.5% were observed.

Conclusions:

  • Acute colonic obstruction due to cancer is associated with poor prognosis.
  • Factors such as advanced disease, older age, delayed treatment, and unprepared bowel contribute to adverse outcomes.
  • Urgent diagnosis and surgical management are critical for potentially improving patient survival.