hrvatski

Surgical treatment for urgent colorectal cancer in University Hospital Dubrava

INTRODUCTION: The strategy of urgent surgical treatment for colorectal cancer have been changed in the last decades. In this retrospective study we analyzed surgical treatment for urgent colorectal cancer in the Department of surgery in our hospital in period of January 2000 till December 2005. PATIENTS AND METHODS: A database of 642 patients who underwent surgery for colorectal cancer at Clinical Hospital Dubrava between the period from January 2000 till December 2005 was reviewed. A 154 (24%) of them underwent urgent surgical treatment because of complication of colorectal cancer. From their medical charts we collected information regarding: age, sex, site of the tumor, type of the operation, Dukes classification, postoperative morbidity and mortality. All these informations we compared with recent literature. RESULTS: From 154 patients who underwent urgent surgical treatment 59 % were male and 41 % were female. The medium age of our patients were 66.5 years, with range from 52 to 88 years. Obstruction is the most common indication for urgent surgical treatment (76 %) followed by perforation (12 %) and bleeding (8 %). The majority of patients had the tumor of the left colon (68 %).Less common sites were in right sided colon (ascending 14 % and cecum 11 %). Hystopatological classification according to Dukes classification reveled: stage A none, stage B 16%, stage C 39% and stage D 55%. Four types of procedures were performed: Hartmann procedure in 32 %, right haemicolectomy in 28 %, Dixon in 8 % and Miles in 4 %. Palliative procedures: ileostomy, reduction of tumor and others were applied in 28 % of our patients . The mortality were 16 %. CONCLUSION: The strategy of urgent surgical treatment for colorectal cancer depends on many factors such as age and general state of patient, localization of tumor, stage of disease, experience of surgeon. In right sided tumor haemicolectomy with primary anastomosis is possible in majority of patients. In left sided colonic carcinomas presenting and requiring urgent surgery the Hartmann procedure is still most often used type of surgery.

kolorektalni karcinom

nije evidentirano