Surgical treatment of acute malignant large bowel obstruction.
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.
Gandrup
P
P
Department of Surgical Gastroenterology, Aalborg Hospital, Denmark.
Lund
L
L
Balslev
I
I
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