Approach to obstructive colorectal cancers and our treatment results

Colorectal cancers are the third most frequent cancer type. Most of the cases aresporadic. Despite the fact that the colorectal cancers are slow growing cancers, 7-47% ofthe cases were admitted to hospital with intestinal obstruction which are tried to be treatedin emergency. These high rates show that screen tests haven?t reached the sufficientlevels. It is reported that preoperative obstruction is a negative prognostic factor incolorectal cancers. Most of the patients are old and have co morbidity and apply tohospital in advanced stages. Preoperative morbidity and mortality are higher according toelective cases; and curative resection rates are barely about 70%s.64 patients operated because of obstructive colorectal cancer between January 2001and December 2006 at General Surgery Department of Akdeniz University Faculty ofMedicine has been taken into this work. It is aimed to research that the treatment methodsof obstructive colorectal cancer patients, who form a serious part of our oncologic surgerypractice in our clinic, their survival results and clinicopathologic factors affecting this.Patients? demographic qualities, tumor?s pathologic details and its localization andour surgery methods are taken into account and it is researched that how these factorsaffect their survival and disease-free survival. LNR is an investigational new notion andrecommended to enter colorectal cancer staging system as for the other cancer types. Forthe first time it is investigated for emergent colorectal cancers. Results are commented incompany with literature and suggestions are made about the management of thesepatients.In our work; we came to conclusions that 1)Primary anastomosis doesn?t increasethe morbidity and mortality rate in obstructive colorectal cancer patients, 2)There is nodifference between proximal and distal localized obstructive colorectal cancer patients interms of short and long term results, 3)It is need to have more researches to assess theeffects of notions like LNR and LVI (Lymph Vascular Invasion) to prognosis.In complicated colorectal cancer cases; our medical and surgical results areaccordant with the world standards.Keywords: Colorectal cancer, obstruction, prognostic factors, lymph node ratio.