Radical resection in obstructing colorectal carcinomas.
Emergency resections of obstructing colorectal carcinomas usually involve only limited rather than radical lymphadenectomy, which may contribute to the poor long-term survival of these patients. Thirty patients with ileus due to colorectal cancer have been included in a prospective follow-up study since January 1995. Seventeen of these underwent potentially curative resections with radical locoregional lymphadenectomy according to current standards of elective oncological surgery; 2 had radical right and 15 had radical left hemicolectomies. Postoperative morbidity was 18%. An 89-year-old patient died following postoperative bleeding from the colostomy site. During the same period, 13 patients with a metastasizing colorectal carcinoma underwent palliative emergency surgery with a resection rate of only 38%. Morbidity and mortality were 69% and 46%, respectively. These results suggest that emergency radical resections can be safely performed in the majority of patients with obstructing colorectal cancer without increasing the complication rate.
Kruschewski
M
M
Department of Surgery, University Medical Center Benjamin Franklin, Free University of Berlin, Germany.
Runkel
N
N
Buhr
H J
HJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods; D003108:Colonic Diseases / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery*; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011183:Postoperative Complications; D011446:Prospective Studies