DRG Category: 329

Mean LOS: 15.7 days

Description SURGICAL: Major Small and Large Bowel Procedures with Major CC

DRG Category: 374

Mean LOS: 5.9 days

Description MEDICAL: Digestive Malignancy with CC

classification section:



Colorectal cancer accounts for about 15% of all malignancies and for about 11% of cancer mortality in both men and women living in the United States and is the second leading cause of death from malignancy. Approximately 50,000 Americans die each year from colorectal cancer. In recent years, both the incidence and the mortality rates have shown a decline, and this is attributed to early identification and improved treatment measures. In 2008, 108,070 new cases of colon cancer and 40,740 new cases of rectal cancer were diagnosed in the United States. The lifetime risk of colorectal cancer is 5.4%, and the 5-year survival rate is 90% if it is diagnosed at an early stage. Unfortunately, only 39% of the cases are identified early. The 5-year survival rate drops to 10% if the colorectal cancer spreads to distant organs and lymph nodes.

Of cancers of the colon, 65% occur in the rectum and in the sigmoid and descending colon, 25% occur in the cecum and ascending colon, and 10% occur in the transverse colon. Most colorectal tumors (95%) are adenocarcinomas and develop from an adenomatous polyp. Once malignant transformation within the polyp has occurred, the tumor usually grows into the lumen of the bowel, causing obstruction, and invades the deeper layers of the bowel wall. After penetrating the serosa and the mesenteric fat, the tumor may spread by direct extension to nearby organs and the omentum. Metastatic spread through the lymphatic and circulatory systems occurs most frequently to the liver as well as the lung, bones, and brain.