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[Colorectal obstruction caused by cancer]

C Ammaturo1, F Cirillo, F Imperatore

  • 1Divisione di Chirurgia d'Urgenza, USL 44, Ospedale Loreto Mare, Napoli.

Minerva Chirurgica
|June 1, 1996
PubMed
Summary

Colorectal cancer obstruction requires emergency surgery, with resection feasible in most cases. However, obstruction significantly worsens 5-year survival rates compared to elective colorectal cancer surgery.

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Area of Science:

  • Oncology
  • Surgical Gastroenterology

Context:

  • Colorectal cancer (CRC) is a significant health concern.
  • Intestinal obstruction is a common and serious complication of CRC.
  • Emergency surgical management of obstructed CRC presents unique challenges.

Purpose:

  • To review a decade of experience in managing colorectal cancer with obstruction.
  • To analyze surgical outcomes and survival rates for obstructed CRC patients.
  • To evaluate evolving surgical strategies for left-sided colonic obstruction.

Summary:

  • This study analyzed 493 colorectal cancer cases, with 425 presenting with obstruction requiring emergency surgery.
  • Resection was achieved in 91% of obstructed cases. Right colon obstructions were managed with right hemicolectomy.

Related Experiment Videos

  • Surgical approaches for left colon obstruction evolved from Hartmann's procedure to single-stage resection-anastomosis with intraoperative colonic irrigation in selected patients.
  • Subtotal colectomy with ileo-sigmoid anastomosis was successful in splenic flexure cancers.

    • Impact:

    • Surgical management of obstructed colorectal cancer can achieve high resection rates.
    • Intraoperative colonic irrigation offers a viable option for selected single-stage procedures in left-sided obstructions.
    • Colorectal cancer with obstruction is associated with significantly poorer 5-year survival (24%) compared to elective cases (41%).