[Complicated colorectal cancer--aspects of surgical tactics].

Abstract

Over the period 2000-2011 (6th m) a total of 856 patients with complicated colorectal cancer are subjected to treatment in the Clinic of surgical diseases--Department of Surgery in University Hospital "Alexandrovska", Sofia. Obturation is the commonest form of complication--47 per cent, perforation within the tumor or diastasis noted in 74 cases (8.6 %), paratumor abscesses and infiltrates--in 7.6 per cent and rectohemorrhage--in 4.2 per cent. The therapeutic and operative approach, and the scope of surgery are dependent on a multitude of factors which should be given due consideration by the surgeon. In each patient presenting complicated colorectal carcinoma it is mandatory to make a precise and individual choice of the extent of operative intervention, consistent with the patient's general condition and contributing to eliminate the life-endangering underlying cause. Postoperative mortality in patients with complicated colorectal cancer is 17.1% whereas in radical operated patients without complicated cancer mortality is only 6.8%.