Background: In recent years, with population aging, there has been an increased number of colorectal cancer cases in elderly patients with severe occlusion symptoms. About 75% of obstructions due to malignant colorectal cancer (10-30%) occur distal to splenic flexure. Methods: The authors evaluated the best surgical therapeutic strategy to be used in cases of left-sided colorectal carcinoma in patients over 65 years old, especially considering the emergency condition, age of patients and efficacy in terms of postoperative morbidity, mortality and 5 years survival rate. Results: The management of left-sided obstructing colorectal carcinoma is controversial. Hartmann’s procedure is the best therapeutic choice in elderly patients. However, resection with intraoperative colonic wash-out and primary anastomosis has favorable outcome in low risk patients. Conclusions: A review of the literature reveals that primary resection and anastomosis for left-sided obstructing CRC is the correct therapeutic strategy in low risk patients with localized, resectable carcinoma, without peritonitis; Hartmann’s procedure should be adopted in doubtful cases and in high risk patients.

Obstructing left sided colorectal cancer. A retrospective single center study / Danzi, Michele; Grimaldi, Luciano; Milone, Marco; Danzi, Roberta; Tammaro, Nicola; Sivero, Luigi. - In: ANNALI ITALIANI DI CHIRURGIA. - ISSN 0003-469X. - 7:7(2019), pp. 1-5.

Obstructing left sided colorectal cancer. A retrospective single center study.

Michele Danzi
;
Luciano Grimaldi;Marco Milone;Roberta Danzi;TAMMARO, NICOLA;Luigi Sivero.
2019

Abstract

Background: In recent years, with population aging, there has been an increased number of colorectal cancer cases in elderly patients with severe occlusion symptoms. About 75% of obstructions due to malignant colorectal cancer (10-30%) occur distal to splenic flexure. Methods: The authors evaluated the best surgical therapeutic strategy to be used in cases of left-sided colorectal carcinoma in patients over 65 years old, especially considering the emergency condition, age of patients and efficacy in terms of postoperative morbidity, mortality and 5 years survival rate. Results: The management of left-sided obstructing colorectal carcinoma is controversial. Hartmann’s procedure is the best therapeutic choice in elderly patients. However, resection with intraoperative colonic wash-out and primary anastomosis has favorable outcome in low risk patients. Conclusions: A review of the literature reveals that primary resection and anastomosis for left-sided obstructing CRC is the correct therapeutic strategy in low risk patients with localized, resectable carcinoma, without peritonitis; Hartmann’s procedure should be adopted in doubtful cases and in high risk patients.
2019
Obstructing left sided colorectal cancer. A retrospective single center study / Danzi, Michele; Grimaldi, Luciano; Milone, Marco; Danzi, Roberta; Tammaro, Nicola; Sivero, Luigi. - In: ANNALI ITALIANI DI CHIRURGIA. - ISSN 0003-469X. - 7:7(2019), pp. 1-5.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/726444
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