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[Complicated colon cancer: the experience at an Operative Surgery Unit].
Ann Ital Chir. 2003 May-Jun; 74(3):327-31.AI

Abstract

INTRODUCTION

Prognosis of colon cancer is worse if complications are present at the moment of diagnosis. The high mortality rate with surgery in emergency in such cases needs a careful reflection about the best suitable operation to perform.

MATERIALS AND METHODS

107 consecutive patients observed along a 9 year-period for colon-rectal cancer are retrospectively analysed. 27 of them were complicated at the presentation for obstruction (19 patients), colon perforation (6 patients) or rectal hemorrhage (2 patients). In the whole experience 5 patients underwent primary resection of the tumour and direct anastomosis; 5 only a decompressive colostomy; 6 were primarily resected and anastomized under the protection of a cecostomy; 6 other patients underwent a Hartmann procedure; 2 were treated with only an intestinal by-pass; 1 was treated with Miles procedure; 1 with an anterior rectal section and the last one was resected-anastomosed in two steps, after a temporary decompressive colostomy.

RESULTS

Intraoperative mortality was of 11.1% (3 patients) and morbidity 18.5% (5 patients). General 5 years survival was 62.1% among the cases complicated at presentation. The recurrence rate was 8.45%. Both these figures are below a statistical significance (p = 0.57).

CONCLUSIONS

The necessity to treat in emergency the colon cancers reduces the possibility to adopt the best rules of modern programmed oncologic surgery giving up the chemotherapy w/o neoadjuvant radiotherapy with which a preoperative down-staging of the tumour were possible. For these reasons in emergency not only mortality and morbidity are higher than in case of elective surgery, but also metastasization and recurrence are worse because of a more difficult radicality in surgery.

Authors+Show Affiliations

Mascitelli E
Divisione Clinicizzata di Chirurgia Generale, Dipartimento di Scienze Chirurgiche Sperimentali e Cliniche, Università degli Studi G. d'Annunzio di Chieti.
Vene ML
No affiliation info available
Tauro A
No affiliation info available
Sigismondi G
No affiliation info available
Picardi N
No affiliation info available

MeSH

AdenocarcinomaAdultAgedAged, 80 and overAnastomosis, SurgicalColonic DiseasesColonic NeoplasmsColostomyFemaleGastrointestinal HemorrhageHospitals, UniversityHumansIntestinal ObstructionIntestinal PerforationItalyMaleMiddle AgedNeoplasm Recurrence, LocalPrognosisRetrospective StudiesSurgery Department, HospitalSurvival AnalysisSurvival Rate

Pub Type(s)

English Abstract
Journal Article

Language

ita

PubMed ID

14677290

Citation

Mascitelli, E, et al. "[Complicated Colon Cancer: the Experience at an Operative Surgery Unit]." Annali Italiani Di Chirurgia, vol. 74, no. 3, 2003, pp. 327-31.
Mascitelli E, Vene ML, Tauro A, et al. [Complicated colon cancer: the experience at an Operative Surgery Unit]. Ann Ital Chir. 2003;74(3):327-31.
Mascitelli, E., Vene, M. L., Tauro, A., Sigismondi, G., & Picardi, N. (2003). [Complicated colon cancer: the experience at an Operative Surgery Unit]. Annali Italiani Di Chirurgia, 74(3), 327-31.
Mascitelli E, et al. [Complicated Colon Cancer: the Experience at an Operative Surgery Unit]. Ann Ital Chir. 2003 May-Jun;74(3):327-31. PubMed PMID: 14677290.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Complicated colon cancer: the experience at an Operative Surgery Unit]. AU - Mascitelli,E, AU - Vene,M L, AU - Tauro,A, AU - Sigismondi,G, AU - Picardi,N, PY - 2003/12/18/pubmed PY - 2004/4/2/medline PY - 2003/12/18/entrez SP - 327 EP - 31 JF - Annali italiani di chirurgia JO - Ann Ital Chir VL - 74 IS - 3 N2 - INTRODUCTION: Prognosis of colon cancer is worse if complications are present at the moment of diagnosis. The high mortality rate with surgery in emergency in such cases needs a careful reflection about the best suitable operation to perform. MATERIALS AND METHODS: 107 consecutive patients observed along a 9 year-period for colon-rectal cancer are retrospectively analysed. 27 of them were complicated at the presentation for obstruction (19 patients), colon perforation (6 patients) or rectal hemorrhage (2 patients). In the whole experience 5 patients underwent primary resection of the tumour and direct anastomosis; 5 only a decompressive colostomy; 6 were primarily resected and anastomized under the protection of a cecostomy; 6 other patients underwent a Hartmann procedure; 2 were treated with only an intestinal by-pass; 1 was treated with Miles procedure; 1 with an anterior rectal section and the last one was resected-anastomosed in two steps, after a temporary decompressive colostomy. RESULTS: Intraoperative mortality was of 11.1% (3 patients) and morbidity 18.5% (5 patients). General 5 years survival was 62.1% among the cases complicated at presentation. The recurrence rate was 8.45%. Both these figures are below a statistical significance (p = 0.57). CONCLUSIONS: The necessity to treat in emergency the colon cancers reduces the possibility to adopt the best rules of modern programmed oncologic surgery giving up the chemotherapy w/o neoadjuvant radiotherapy with which a preoperative down-staging of the tumour were possible. For these reasons in emergency not only mortality and morbidity are higher than in case of elective surgery, but also metastasization and recurrence are worse because of a more difficult radicality in surgery. SN - 0003-469X UR - https://www.unboundmedicine.com/medline/citation/14677290/[Complicated_colon_cancer:_the_experience_at_an_Operative_Surgery_Unit]_ DB - PRIME DP - Unbound Medicine ER -