Colorectal carcinoma in Port Harcourt

ABSTRACT

Background: Colorectal carcinoma, the commonest malignant tumour of the gastrointestinal tract, is rather uncommon in Nigeria, occurring often at a relatively early age. Aim: To report experience with colorectal carcinoma in the University of Port Harcourt Teaching Hospital (UPTH). Methodology: Patients treated for colorectal cancer at the UPTH over a 19- year period (1987-2006) and had complete information, were studied. Data were collected from patients/' case notes, ward registers, theatre records and histopathology reports. The data were analyzed with respect to age, gender, clinical features and investigations. Other indices studied were treatment, postoperative complications, duration of hospital stay and outcome/mortality. Results: The records of 36 cases were available for study. Male to female ratio was 21. The 41-60 year age range recorded the highest number of cases (52.8%). Weight loss, change in bowel habit, rectal bleeding, and abdominal/rectal mass constituted the main symptoms. Diagnosis was made from clinical examination, double contrast barium enema and proctosigmoidoscopy/biopsy. The rectum and caecum/ascending colon were commonly affected. The appropriate surgical treatment was duly performed. Some patients had postoperative adjuvant treatment using 5-fluorouracil only. Postoperative complications included surgical site infection, persistent perineal discharge, perineal pain, and obstruction of colostomy, hepatic encephalopathy and obstructive uropathy. The average duration of hospital stay was 12 days and follow-up assessment ranged from 3 months to 14 years. The postoperative mortality at three years was high. Conclusion: Colorectal carcinoma is relatively uncommon in our environment. The younger age groups tend to be more affected. Late presentation resulted in poor survival in spite of surgical treatment and adjuvant therapy