Evaluation of current therapeutic approach to obstructive and perforated colorectal cancers
| Autor: | Metin Kement, Selçuk Kaya, Levent Kaptanoglu, Önder Altin, Nejdet Bildik, Ahmet Şeker, Hasan Fehmi Küçük, Yunus Emre Altuntas |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Blood transfusion Delayed Diagnosis Colorectal cancer medicine.medical_treatment Perforation (oil well) 03 medical and health sciences Therapeutic approach 0302 clinical medicine Postoperative Complications medicine Humans Emergency Treatment Retrospective Studies business.industry Mortality rate Postoperative complication Retrospective cohort study Perioperative medicine.disease Surgery Anesthesiology and Pain Medicine Intestinal Perforation 030220 oncology & carcinogenesis Emergency Medicine business Colorectal Neoplasms 030217 neurology & neurosurgery Intestinal Obstruction |
| Zdroj: | Ulusal travma ve acil cerrahi dergisi = Turkish journal of traumaemergency surgery : TJTES. 25(6) |
| ISSN: | 1306-696X |
| Popis: | Background Late diagnosis continues to be a significant problem in the treatment of colorectal cancer (CRC). Most cases require emergency surgical intervention due to acute intestinal obstruction or perforation. This retrospective study was formed from an assessment of the clinical presentation, treatment, early results, and survival of patients with CRC undergoing emergency surgery for acute obstruction or perforation. Methods Between 2012 and 2017, 612 patients underwent surgery for CRC. In all, 179 patients who required emergency treatment were retrospectively evaluated according to age, gender, significant comorbidities, physiological status, surgical indications, tumor location, tumor stage, perioperative blood transfusion rate, type of surgery, and the length of the operation and hospitalization. Results In total, 152 (85%) patients had a complete obstruction and 27 (15%) patients had a perforation. A major postoperative complication was identified nearly in half of the patients. The overall mortality rate was 12% (22 patients). Mortality was seen in 12% (18 patients) cases received surgery due to obstruction and in 15% (four patients) cases received surgery due to perforation. Perioperative blood transfusion and a high Acute Physiology and Chronic Health Evaluation II score were independent factors that predicted a major complication. Advanced age and perioperative blood transfusion were statistically independent prognostic factors for mortality. Conclusion Consisted with the findings of studies in the literature, the results of this study also revealed a high perioperative morbidity and mortality rate in patients with CRC who required urgent surgery. Our findings suggest that early detection and treatment of CRC with screening programs can be life-saving. |
| Databáze: | OpenAIRE |
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