Emergency surgery for obstructed colorectal cancer in Vietnam

Abstract

The benefit of one-stage surgery in emergency surgery for obstructing colorectal cancer (oCRC) by colorectal surgeons has increased during the last century but little is known about the outcomes of this technique conducted by general surgeons in developing countries. This retrospective study was to evaluate the outcomes of emergency surgery for oCRC in a general surgery unit. A retrospective review of data from 1175 patients who underwent colorectal surgery between January 2013 and January 2018 was performed. Among these, a total of 186 patients with oCRC who underwent surgery within 24h of hospital admission were analyzed. For patients with resectable right-sided oCRC, one-stage surgery was performed. For left-sided oCRC, primary anastomosis was mainly attempted; otherwise, a stoma was formed. The rates of primary resection, PRa, stoma, mortality, and morbidity were evaluated. Among 186 patients, oCRC involving the right colon, left colon, and rectum were found in 33.3%, 59.1% and 7.5% respectively. Primary resection and anastomosis were performed in 100%, 44.7%, and 0% of patients with oCRC in the right colon, left colon, and rectum respectively. The complication incidence based on Clavien-Dindo grade III or higher was 16.1% and the mortality rate was 7.5%. The median length of hospital stay was 8.5 days, ranging from 2 to 70 days. General surgeons with colorectal surgery experience can still manage oCRC effectively. Primary resection and anastomosis for left-sided oCRC is safe in selective patients. The emergency surgery for oCRC could be benefit with the participation of colorectal surgeons.