Complicated colorectal cancer

The aim of this study was to investigate postoperative und long-term result s after radical tumor surgery in complicated colorectal cancers. One hundre d and twenty-six (11.7%) of 1071 patients treated for large bowel cancer be tween 1986 and 1997 were operated on for bowel obstruction (84; 7.8 %) or p erforation (42; 3.9%). Postoperative mortality was significantly higher in complicated than in uncomplicated cancers (19% after bowel obstruction, 38% after perforation, 6 % in uncomplicated cases). Development of preoperativ e organ dysfunction determined survival in both complications. Mortality af ter perforations was influenced by the degree of peritonitis and tumor stag e, while patients after bowel obstruction were at greater risk in the case of cardiac comorbidity. Long-term results depended on tumor stage but not o n complications. Our concept of radical tumor surgery in emergency operatio ns was supported by the fact that long-term results of patients surviving t he acute stage of complicated colorectal cancers did not differ from those of patients with uncomplicated carcinomas.