title: Surgical treatment of acute malignant large bowel obstruction.
abstract: OBJECTIVE
  To evaluate the morbidity and mortality in all patients operated on urgently for acute large bowel obstruction caused by carcinoma of the colon or rectum during a 10 year period.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Aalborg Hospital, Denmark.
  
  
  METHODS
  156 consecutive patients operated on for obstructing primary colorectal cancers.
  
  
  METHODS
  Operations done, morbidity and mortality.
  
  
  RESULTS
  95 patients (61%) had advanced disease (Dukes' stage C or "D") and their median age was 73 years (range 38-93). 97 had the obstructing lesion resected with a 30 day mortality of 5%. 43 patients underwent primary resection and 4 died (9%), and 54 underwent staged resection with one death (2%). Complications were common, particularly after staged resections, median hospital stay being 19 days after primary, compared with 30 days after staged resection. 59 patients (38%) had palliative operations with 29 deaths (49%); in 39 the tumor was completely unresectable.
  
  
  CONCLUSIONS
  Patients with obstructing primary colorectal cancers are a high risk group who are characterised by advanced disease and old age. Only prospective trials comparing different operations can assess whether it is possible to achieve a reduction in mortality.
authors.affiliation: Department of Surgical Gastroenterology, Aalborg Hospital, Denmark.
authors.forename: P
authors.initials: P
authors.lastname: Gandrup
authors.forename: L
authors.initials: L
authors.lastname: Lund
authors.forename: I
authors.initials: I
authors.lastname: Balslev
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D003108:Colonic Diseases / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D011183:Postoperative Complications / Q000401:mortality; D012086:Reoperation; D012189:Retrospective Studies