Surgical management of large bowel cancer 1983-1988, University of Calabar Teaching Hospital audit

Thirty one consecutive patients with histologically confirmed colorectal carcinoma were treated at the University of Calabar Teaching Hospital (UCTH), Calabar between January 1983 and December 1988 inclusive. On presentation the disease was advanced in 15 patients, and in 13 of these it was complicated by obstruction (10), fistulation (two), and penetration (three). In the colonic group, curative resection was feasible in eight (66,7 pc) as opposed to 10(52,6 pc) in the rectal group. Overall resectability and operative mortality rates were 58 pc and 10 pc respectively. Definitive surgery was not feasible in, or refused by a total of nine (24 pc) patients because of poverty (four), religious objection to blood transfusion (one), fear of colostomy (three) and for very advanced disease (one). We consider that public education on the disease, colostomy and its management as well as a greater striving to perform restorative operations on suitably selected cases of rectal carcinoma could improve our results in the surgical management of the disease.