engleski

Urgent vs. elective colorectal cancer treatment

In spite of modern diagnostic tools and protocols, in a number of cases colorectal cancer is diagnosed only after it causes a life-threatening condition, such as obstruction or colon perforation. Such patients must be operated in emergency setting, with only brief preoperative evaluation and preparation. This varies considerably from elective surgery where it is customary to perform optimal preoperative evaluation and colon preparation and the patient is in good general condition. Our goal was to analyze the outcome of surgical treatment of colorectal cancer, based on whether it was carried out in emergency setting. In this study we retrospectively collected data regarding patients operated for colorectal cancer. Patients operated in our hospital from 2000 to 2005 were analyzed. Urgently operated patients were identified and analyzed regarding their sex, age, type of operation, cause of urgent treatment and patohistologic cancer staging. They were then compared with patients that underwent elective surgery for colorectal cancer in the same period. We specifically compared these two groups regarding cancer staging according to Dukes' classification, type of operation, postoperative morbidity and more. Altogether, 642 cases were included in the study: 488 elective cases and 154 urgent cases. Patients undergoing urgent surgery and patients undergoing elective surgery did not differ significantly regarding age and sex. We found that the patients undergoing urgent surgery had more advanced cancer, more postoperative complications and higher postoperative mortality than electively operated patients. Urgently operated patients had longer postoperative stay as well. In this study not a single urgently operated patient had the cancer limited to mucosa and submucosa (Dukes A). This study underscores the importance of early detection of colorectal cancer and optimal preoperative preparation of patients.

colorectal cancer

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