The effectiveness of surgical treatment of patients with urgent complications of colorectal cancer

Objective. To estimate the effectiveness of surgical treatment of patients with colorectal cancer urgent complications at the regional level; to establish the type of surgery depending on the location of the tumor in the colon; to determine the nature of the complications in the postoperative period. Material and methods. Retrospective research in which the information about 1098 patients with urgent forms of a colon cancer treated during the period from 2001 to 2013 on the territory of Smolensk and the Smolensk region was conducted. Results. In urgent complications of cancer of the right half of the colon most commonly the sided hemicolectomy with the formation of ileotransverse anastomosis was performed (93.9%, p < 0.05). In complicated tumors of the left half of the colon Hartmann's resections were performed more often (p < 0.05). From multi-stage operations with removal of the tumor in the second step often transversostomia was held followed, after 1-2 months, by the radical operation. Relaparotomia percentage was 14.7%. Most of the reoperations were debridement and drainage of the abdominal cavity (56.2%), colostomy with drainage of the abdominal cavity (17.3%). Such operations as reresection of anastomosis and reconstruction of colostoma were executed in 7.1 and 8.9% of cases respectively (p < 0.05). Suppuration of postoperative wound was observed in 31.1% of cases, colostoma necrosis, retroperitoneal cellulitis were recorded in 3.9%, an abscess in the abdomen - in 3%, anastomotic leakage - in 1.9% of cases. The mortality rate was 19.1%. Conclusion. There is a clear relationship between the nature of the surgery and the number of postoperative complications. It was noted that the one-stage operations were more often accompanied by postoperative complications than the multi-stage surgery.

Alvarez-Pérez J.A., Baldonedo-Cernuda R.F., García-Bear I., Truán-Alonso N., Pire-Abaitua G., Alvarez-Martínez P. Risk factors in patients older then 70 years with complicated colorectal carcinoma. Cir. Esp. 2006; 79 (1): 36-41.

Coco C., Verbo A., Manno A., Mattana C., Covino M., Pedretti G. et al. Impact of emergency surgery in the outcome of rectal and left colon carcinoma. World J. Surg. 2006; 29 (11): 1458-64.

Merkel S., Meyer C., Paradopoulos T., Meyer T., Hohenberger W. Urgent surgery in colon carcinoma. Zetrabl. Chir. 2007; 132 (1): 16-25.

Rudra K.М., Charles A.M. Surgical management of obstructed and perforated colorectal cancer: still debating and unresolved issues. Colorectal Cancer. 2013; 2 (6): 573-84.

Tsai H.L., Hsieh J.S., Yu F.J., Wu D.C., Chen F.M., Huang C.J. Perforated colonic cancer presenting as intra-abdominal abscess. Int. J. Colorectal Dis. 2007; 22 (1): 15-9.