Skip to main content
Top
Published in: Langenbeck's Archives of Surgery 1/2009

01-01-2009 | Original Article

Results of surgery for colorectal carcinoma with obstruction

Authors: Antonios-Apostolos K. Tentes, Charalambos G. Mirelis, Stilianos Kakoliris, Odisseas S. Korakianitis, Ioannis G. Bougioukas, Evanthia G. Tsalkidou, Athanasios I. Xanthoulis, Konstantina A. Bekiaridou, Abraham I. Dimoulas

Published in: Langenbeck's Archives of Surgery | Issue 1/2009

Login to get access

Abstract

Background/aims

Emergency surgery for obstructing colorectal carcinoma is thought to be associated with poor survival. The aim of the study is to assess the results of surgery for obstructing colorectal cancer.

Materials and methods

From 1987 to 2004, 80 patients underwent emergency surgery for completely obstructing colorectal carcinoma (COC), and 171 patients underwent elective surgery for non-obstructing cancer (NOC). Morbidity, mortality, and the late outcome were assessed.

Results

The groups were comparable for age, gender, tumor distribution, histopathologic characteristics, stage, morbidity, concomitant operations, recurrence, and sites of recurrence. High ASA class, poor performance status, and high mortality rate were recorded in COC group (p < 0.05). Mortality was related to ASA class (p < 0.001), performance status (p < 0.001), and obstruction (p = 0.014). ASA class was the single independent factor of morbidity (p < 0.001). The groups were comparable for survival (p > 0.05).

Conclusions

Obstructing colorectal carcinoma seems to be associated with high mortality rate, but long-term survival seems to be the same with non-obstructing carcinoma.
Literature
1.
go back to reference Fielding L, Wells B (1974) Survival after primary and after staged resection for large bowel obstruction caused by cancer. Br J Surg 61:16–18PubMedCrossRef Fielding L, Wells B (1974) Survival after primary and after staged resection for large bowel obstruction caused by cancer. Br J Surg 61:16–18PubMedCrossRef
2.
go back to reference Welch J, Donaldson G (1974) Management of severe obstruction of the large bowel due to malignant disease. Am J Surg 127:492–499PubMedCrossRef Welch J, Donaldson G (1974) Management of severe obstruction of the large bowel due to malignant disease. Am J Surg 127:492–499PubMedCrossRef
3.
go back to reference Umpleby H, Williamson R (1984) Survival in acute obstructing colorectal carcinoma. Dis Colon Rectum 27:299–304PubMedCrossRef Umpleby H, Williamson R (1984) Survival in acute obstructing colorectal carcinoma. Dis Colon Rectum 27:299–304PubMedCrossRef
4.
go back to reference Ohman U (1982) Prognosis in patients with obstructing colorectal carcinoma. Am J Surg 143:742–747PubMedCrossRef Ohman U (1982) Prognosis in patients with obstructing colorectal carcinoma. Am J Surg 143:742–747PubMedCrossRef
5.
go back to reference Irvin T, Greaney M (1977) The treatment of colonic carcinoma presenting with intestinal obstruction. Br J Surg 64:741–744PubMedCrossRef Irvin T, Greaney M (1977) The treatment of colonic carcinoma presenting with intestinal obstruction. Br J Surg 64:741–744PubMedCrossRef
6.
go back to reference Phillips R, Hittinger R, Fry J, Fielding L (1985) Malignant large bowel obstruction. Br J Surg 72:296–302PubMedCrossRef Phillips R, Hittinger R, Fry J, Fielding L (1985) Malignant large bowel obstruction. Br J Surg 72:296–302PubMedCrossRef
7.
go back to reference Serpell J, McDermott F, Katrivessis H, Hughes E (1989) Obstructing carcinomas of the colon. Br J Surg 76:965–969PubMedCrossRef Serpell J, McDermott F, Katrivessis H, Hughes E (1989) Obstructing carcinomas of the colon. Br J Surg 76:965–969PubMedCrossRef
8.
go back to reference Lee Y, Law W, Chu K, Poon R (2001) Emergency surgery for obstructing colorectal cancers: a comparison between right-sided and left-sided lesions. Am Coll Surg 192:719–725CrossRef Lee Y, Law W, Chu K, Poon R (2001) Emergency surgery for obstructing colorectal cancers: a comparison between right-sided and left-sided lesions. Am Coll Surg 192:719–725CrossRef
9.
go back to reference Runkel N, Hinz U, Lehnert T, Buhr H, Herfarth C (1998) Improvement outcome after emergency surgery for cancer of the large intestine. Br J Surg 85:1260–1265PubMedCrossRef Runkel N, Hinz U, Lehnert T, Buhr H, Herfarth C (1998) Improvement outcome after emergency surgery for cancer of the large intestine. Br J Surg 85:1260–1265PubMedCrossRef
10.
go back to reference Alvarez J, Baldonedo R, Bear I, Truan N, Pire G, Alvarez P (2005) Obstructing colorectal carcinoma: outcome and risk factors for morbidity and mortality. Dig Surg 22:174–181PubMedCrossRef Alvarez J, Baldonedo R, Bear I, Truan N, Pire G, Alvarez P (2005) Obstructing colorectal carcinoma: outcome and risk factors for morbidity and mortality. Dig Surg 22:174–181PubMedCrossRef
11.
go back to reference Garcia-Valdecasas J, Llovera J, De Lacy A, Reverter J, Grande L, Fuster J, Cugat E, Visa J, Pera C (2001) Obstructing colorectal carcinomas. Prospective study. Dis Colon Rectum 34:759–762CrossRef Garcia-Valdecasas J, Llovera J, De Lacy A, Reverter J, Grande L, Fuster J, Cugat E, Visa J, Pera C (2001) Obstructing colorectal carcinomas. Prospective study. Dis Colon Rectum 34:759–762CrossRef
12.
go back to reference Wilder J, Dockerty M, Wangh J (1961) A clinicopathologic study of obstructing carcinomas of the right portion of the colon. Surg Gynecol Obstet 113:353–359PubMed Wilder J, Dockerty M, Wangh J (1961) A clinicopathologic study of obstructing carcinomas of the right portion of the colon. Surg Gynecol Obstet 113:353–359PubMed
13.
go back to reference Wang H, Lin J, Mou C, Lin T, Chen W, Jiang J, Yang S (2004) Long-term prognosis of patients with obstructing carcinoma of the right colon. Am J Surg 187:497–500PubMedCrossRef Wang H, Lin J, Mou C, Lin T, Chen W, Jiang J, Yang S (2004) Long-term prognosis of patients with obstructing carcinoma of the right colon. Am J Surg 187:497–500PubMedCrossRef
14.
go back to reference Vidger L, Tsur N, Huber M, Mahagna M, Amir I (1985) Management of obstructive carcinoma of the left colon; comparative study of staged and primary resection. Arch Surg 120:825–828 Vidger L, Tsur N, Huber M, Mahagna M, Amir I (1985) Management of obstructive carcinoma of the left colon; comparative study of staged and primary resection. Arch Surg 120:825–828
15.
go back to reference Isbister W, Prasad J (1997) Emergency large bowel surgery: a 15-year audit. Int J Colorectal Dis 12:285–290PubMedCrossRef Isbister W, Prasad J (1997) Emergency large bowel surgery: a 15-year audit. Int J Colorectal Dis 12:285–290PubMedCrossRef
16.
go back to reference Re Mine G, Dozois R (1981) Hartmann’s procedure: it’s use with complicated carcinomas of sigmoid colon and rectum. Arch Surg 116:630–633 Re Mine G, Dozois R (1981) Hartmann’s procedure: it’s use with complicated carcinomas of sigmoid colon and rectum. Arch Surg 116:630–633
17.
go back to reference Lau P, Lo C, Law W (1995) The role of one-stage surgery in acute left-sided colonic obstruction. Am J Surg 169:406–409PubMedCrossRef Lau P, Lo C, Law W (1995) The role of one-stage surgery in acute left-sided colonic obstruction. Am J Surg 169:406–409PubMedCrossRef
18.
go back to reference Longo W, Virgo K, Johnson F, Oprian C, Vernava A, Wade T, Phelan M, Henderson W, Daley J, Khuri S (2000) Risk factors for morbidity and mortality after colectomy for colon cancer. Dis Colon Rectum 43:83–91PubMedCrossRef Longo W, Virgo K, Johnson F, Oprian C, Vernava A, Wade T, Phelan M, Henderson W, Daley J, Khuri S (2000) Risk factors for morbidity and mortality after colectomy for colon cancer. Dis Colon Rectum 43:83–91PubMedCrossRef
19.
go back to reference Alvarez J, Baldonedo R, Bear I, Truan N, Pire G, Alvarez P (2005) Presentation, treatment, and multivariate analysis of risk factors for obstructive and perforative colorectal carcinoma. Am J Surg 190:376–382PubMedCrossRef Alvarez J, Baldonedo R, Bear I, Truan N, Pire G, Alvarez P (2005) Presentation, treatment, and multivariate analysis of risk factors for obstructive and perforative colorectal carcinoma. Am J Surg 190:376–382PubMedCrossRef
20.
go back to reference Smothers L, Hynan L, Fleming J, Turnage R, Simmang C, Anthony T (2003) Emergency surgery for colon carcinoma. Dis Colon Rectum 46:24–30PubMedCrossRef Smothers L, Hynan L, Fleming J, Turnage R, Simmang C, Anthony T (2003) Emergency surgery for colon carcinoma. Dis Colon Rectum 46:24–30PubMedCrossRef
21.
go back to reference Carraro P, Segala M, Cesana B, Tiberio G (2001) Obstructing colonic cancer: failure and survival patterns over a ten-year follow-up after one-stage surgery. Dis Colon Rectum 44:243–250PubMedCrossRef Carraro P, Segala M, Cesana B, Tiberio G (2001) Obstructing colonic cancer: failure and survival patterns over a ten-year follow-up after one-stage surgery. Dis Colon Rectum 44:243–250PubMedCrossRef
22.
go back to reference Minster J (1964) Comparison of obstructing and non-obstructing carcinoma of the colon. Cancer 17:242–247PubMedCrossRef Minster J (1964) Comparison of obstructing and non-obstructing carcinoma of the colon. Cancer 17:242–247PubMedCrossRef
23.
go back to reference Kruschewski M, Runkel N, Buhr H (1998) Radical resection in obstructing colorectal carcinomas. Int J Colorectal Dis 13:247–250PubMedCrossRef Kruschewski M, Runkel N, Buhr H (1998) Radical resection in obstructing colorectal carcinomas. Int J Colorectal Dis 13:247–250PubMedCrossRef
Metadata
Title
Results of surgery for colorectal carcinoma with obstruction
Authors
Antonios-Apostolos K. Tentes
Charalambos G. Mirelis
Stilianos Kakoliris
Odisseas S. Korakianitis
Ioannis G. Bougioukas
Evanthia G. Tsalkidou
Athanasios I. Xanthoulis
Konstantina A. Bekiaridou
Abraham I. Dimoulas
Publication date
01-01-2009
Publisher
Springer-Verlag
Published in
Langenbeck's Archives of Surgery / Issue 1/2009
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-008-0307-5

Other articles of this Issue 1/2009

Langenbeck's Archives of Surgery 1/2009 Go to the issue