ABSTRACT
OBJECTIVE: Colorectal cancer is one of the most frequent types of malignant neoplasms. Age is a risk factor for this disease, with 75% of cases diagnosed in patients older than 65 years. Complications such as obstruction, hemorrhage, and perforation are present in more than one-third of cases and require emergency treatment. We aim to analyze the profile of elderly patients undergoing surgery for complicated colorectal cancer, and to evaluate factors related to worse short-term prognosis. METHODS: A retrospective analysis of patients who underwent emergency surgical treatment for complicated colorectal cancer was performed. Demographics, clinical, radiological and histological data were collected. RESULTS: Sixty-seven patients were analyzed. The median age was 72 years, and almost half (46%) of the patients were female. Obstruction was the most prevalent complication at initial presentation (72%). The most common sites of neoplasia were the left and sigmoid colon in 22 patients (32.8%), and the right colon in 17 patients (25.4%). Resection was performed in 88% of cases, followed by primary anastomosis in almost half. The most frequent clinical stages were II (48%) and III (22%). Forty-three patients (65.7%) had some form of postoperative complication. Clavien-Dindo grades 1, 2, and 4, were the most frequent. Complete oncologic resection was observed in 80% of the cases. The thirty-day mortality rate was 10.4%. Advanced age was associated with worse morbidity and mortality. CONCLUSION: Elderly patients with complicated colorectal cancer undergoing emergency surgery have high morbidity and mortality rates. Advanced age is significantly associated with worse outcomes.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Colorectal Neoplasms/surgery , Colorectal Neoplasms/mortality , Emergency Treatment/mortality , Postoperative Complications/mortality , Prognosis , Brazil , Colorectal Neoplasms/complications , Colorectal Neoplasms/pathology , Comorbidity , Retrospective Studies , Risk Factors , Age Factors , Statistics, Nonparametric , Intensive Care Units/statistics & numerical data , Length of Stay , Neoplasm StagingABSTRACT
Os autores apresentam a casuística da 3: Clínica Cirúrgica do Hospital das Clínicas da Faculdade de Medicina da Universidade de Säo Paulo (16 casos), e da clínica privada de dois dos autores (3 casos), totalizando 19 casos de tumor de desmóide, sendo 13 desmóides abdominais, cinco extra abdominais e um intra abdominal. Realizam também revisäo bibliográfica sobre o assunto comparando seus dados com os da literatura e tecem comentários quanto à etiologia, incidência, localizaçäo, achados clínicos, diagnóstico, tratamento, evoluçäo e prognóstico dos tumores desmóides