ABSTRACT
BACKGROUND/AIMS: Emergency surgery for obstructing colorectal carcinoma is thought to be associated with poor survival. The aim of the study is to assess the results of surgery for obstructing colorectal cancer. MATERIALS AND METHODS: From 1987 to 2004, 80 patients underwent emergency surgery for completely obstructing colorectal carcinoma (COC), and 171 patients underwent elective surgery for non-obstructing cancer (NOC). Morbidity, mortality, and the late outcome were assessed. RESULTS: The groups were comparable for age, gender, tumor distribution, histopathologic characteristics, stage, morbidity, concomitant operations, recurrence, and sites of recurrence. High ASA class, poor performance status, and high mortality rate were recorded in COC group (p < 0.05). Mortality was related to ASA class (p < 0.001), performance status (p < 0.001), and obstruction (p = 0.014). ASA class was the single independent factor of morbidity (p < 0.001). The groups were comparable for survival (p > 0.05). CONCLUSIONS: Obstructing colorectal carcinoma seems to be associated with high mortality rate, but long-term survival seems to be the same with non-obstructing carcinoma.
Subject(s)
Colonic Diseases/surgery , Colorectal Neoplasms/surgery , Emergencies , Intestinal Obstruction/surgery , Adult , Aged , Aged, 80 and over , Colonic Diseases/mortality , Colonic Diseases/pathology , Colorectal Neoplasms/mortality , Colorectal Neoplasms/pathology , Elective Surgical Procedures/statistics & numerical data , Female , Greece , Hospital Mortality , Humans , Intestinal Obstruction/mortality , Intestinal Obstruction/pathology , Kaplan-Meier Estimate , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Staging , Neoplasm, Residual/mortality , Neoplasm, Residual/pathology , Postoperative Complications/mortality , Prognosis , Retrospective Studies , Risk FactorsABSTRACT
BACKGROUND: Large ventral incisional hernias are frequently repaired either by open or by laparoscopic mesh technique. The technique recommended by Nuttall has been used for the repair of large subumbilical incisional hernias but has not been popularized. MATERIALS AND METHODS: From 1991 to 2005, 21 patients, mean age 64.6 +/- 13 (44-86) years, underwent repair of large subumbilical incisional hernia with the Nuttall technique by which the rectus muscles are detached from the symphysis pubis and transposed to the opposite side. The exerted tension is minimal to the underlying tissues, and no prosthetic material is required to reinforce the abdominal wall. RESULTS: Morbidity was recorded in five patients (23.8%). The median follow-up time was 84 months, and the recurrence rate was 4.8% (one patient). CONCLUSIONS: Although a small number of patients have undergone repair with the Nuttall technique, the long-term results of the method seem to be encouraging for the repair of large subumbulical incisional hernias.
