Efficacy and Safety of Emergency Resection in Treatment of Acutely Obstructing Colonic Cancer

Document Type : Original Article

Authors

General Surgery Department, Faculty of medicine, Beni-Suef University.

Abstract

Background: Surgical intervention is usually required for patients presenting with bowel obstruction secondary to colon cancer. However, urgent surgical intervention for such cases has higher morbidity and mortality rates. This study was done to evaluate the efficacy and safety of emergency resection in patients with colonic cancer presenting with acute bowel obstruction. Patients and methods: This prospective investigation included 20 patients diagnosed with obstructing colon cancer. For right-sided cases, right or extended right hemicolectomy was performed, followed by a primary anastomosis. Inleft-sidedlesions, resection was done, followed by exteriorization of the two ends.Mortality, morbidity, and length of hospitalization were considered to be indicators of safety, whereas surgical cut margin status and nodal harvesting were the indicators of efficacy. Results: Sigmoid colon was the commonest affected site (50%), followed by descending colon (25%), hepatic flexure (20%), and caecum (5%).Operative time ranged between 90 and 131 minutes, with no intraoperative complications.The included patients were allowed to start oral fluid on the second to the fifth post-operative day. The duration of hospitalization had a mean value of 5.2 days.The number of resected and infiltrated lymph nodes had mean values of 14.65 and 5.7, respectively, with a lymph node ratio ranging between 0.21 and 0.64. No mortality or serious post-operative complications was encountered in the current study. Conclusion: Surgical resection in patients with obstructed cancer colon is associated with safe perioperative and good oncological outcomes.

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References

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