Management of complicated colorectal cancer in Benghazi hospitals

Abstract

Introduction: Colorectal cancer (CRC) is the third most frequent malignant disease in men and second most frequent in women. The treatment of emergency cases of CRC presented with complication is different than elective controlled cases. Aim: of this study is to find the best way to treat a patient admitted as an emergency case of complicated colorectal cancer. Methods: The medical data of 102 patients was retrospectively evaluated for those who were admitted as emergency cases with acute or subacute intestinal obstruction, perforation or bleeding colorectal cancer to Al-Jalla Hospital, Benghazi Libya. Three different emergency treatment methods were received as follow: · Tumor resection, · Damage control procedure with elective or semi elective resection, and · No radical treatment. Primary endpoints were 6 months mortality and morbidity. Secondary endpoints were length of hospital stay, number of lymph nodes, rate of radical R0 resections, and the number of patients who had received chemo-radiotherapy. Results: 55 patients had immediate resection and colostomy. 33 patients were inoperable because the cancer was too advanced or they were too ill to tolerate an operation. 10 had damage control followed by elective resection. There was no statistically proven significant difference between immediate resections and 2-stage treatment. The patients who underwent staged treatment had a higher possibility of receiving a laparoscopic resection. Conclusion: This study couldn't determine which treatment is better, even with using staging resection.