[Management of colorectal resections for treatment of neoplastic intestinal occlusions. Experience of surgery clinic No III, Cluj-Napoca].
OBJECTIVE
We analyzed the clinical results of different techniques of resection for malignant colorectal (primary or staged) obstruction.


METHODS
The subjects of this retrospective nonrandomized clinical study were 165 patients with malignant colorectal occlusion who underwent surgery treatment in our Department between 2002-2006. Patients with peritonitis or treated by means of permanent colostomy, palliative anastomosis, primary Hartman resection and rectal excision were excluded.


RESULTS
Patients with large bowel obstruction caused by obstructive malignant colorectal lesions underwent either one-stage primary resection with anastomosis (77 patients) or staged interventions (88 patients). There were no differences in age, sex, comorbidities, tumor staging, serum preoperative levels of hemoglobin and proteins between the two groups of patients defined by the different surgical techniques. Regarding mortality and morbidity following surgical treatment for large bowel obstruction no significant difference among the two groups (p > 0.05) or the fistula rate (p = 0.435) was obtained. Moreover, results showed a higher incidence of mortality (11.8% vs 7.8%), morbidity (13.6 vs 10.4) and increased hospitalization period (p = 0.03) among the patients that undergone series resections.


CONCLUSIONS
One stage primary resections with anastomosis of the large bowel can be performed safely in case of emergency whenever patient comorbidities and local conditions do not stand as major restrictions.
Iancu
C
C
Clinica Chirurgie 3, Spital Clinic de Adulţi, Cluj-Napoca.
Osian
G
G
Mocan
L
L
Mocan
Teodora
T
Zaharie
F
F
Todea-Iancu
Dana
D
Bălă
O
O
Bodea
Raluca
R
Al-Hajjar
N
N
Pop
F
F
Puia
I C
IC
Graur
F
F
Munteanu
D
D
Vlad
L
L
D000368:Aged; D003082:Colectomy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D004630:Emergencies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012383:Romania / Q000453:epidemiology; D016019:Survival Analysis; D016896:Treatment Outcome