Emergency surgery for complicated colorectal cancer in central Brazil

Abstract

Objectiveto report clinical and pathological features of patients with colorectal cancer diagnosed during emergency abdominal surgery. Methodsrecords of 107 patients operated between 2006 and 2010 were reviewed. Resultsthere were 58 women and 49 men with mean age of 59.8 years. The most frequent symptoms were: abdominal pain (97.2%), no bowel movements (81.3%), vomiting (76.6%), and anorexia (40.2%). Patients were divided into five groups: obstructive acute abdomen (n=68), obstructive acute perforation (n=21), obstructive acute inflammation (n=13), abdominal sepsis (n=3), and severe gastrointestinal bleeding (n=2). Tumors were located in the rectosigmoid (51.4%), transverse colon (19.6%), ascendent colon (12.1%), descendent colon (11.2%), and 5.6% of the cases presented association of two colon tumors (synchronic tumors). The surgical treatment was: tumor resection with colostomy (85%), tumor resection with primary anastomosis (10.3%), and colostomy without tumor resection (4.7%). Immediate mortality occurred in 33.4% of the patients. Bivariate analysis of sex, tumor location and stage showed no relation to death (p>0.05%). Conclusionscolorectal cancer may be the cause of colon obstruction or perfuration in patients with nonspecific colonic complaints. Despite the high mortality rate, resection of tumor is feasible in most patients.