Evaluation of operative risk in emergency treatment of neoplastic left colon obstruction: Personal experience

Abstract

AIM OF THE STUDY: To analyse the risk factors in the treatment of intestinal obstruction due to colorectal carcinoma. The treatment of neoplastic obstruction of the right colon until the splenic flexure is well defined: right hemicolectomy, enlarged right hemicolectomy. Otherwise the treatment of the obstruction due to left colon carcinoma beyond left flexure is not standardized.

MATERIAL AND METHODS: The Authors report on a consecutive series of 15 patients, classified according to Colorectal Tumours Emergencies Score (CTES), based on the analysis of 4 risks factors: colic, perforation, serum albumin, concurrent cardiovascular disease, chronic renal insufficiency. Each patient has been ranked in three classes of risk: low (CTES < 4), moderate (CTES 4-12), and high (CTES > 12).

CONCLUSIONS: Referring to this classification the Authors consider the choice of surgical treatment. When general conditions of the patient permit, it seems preferable to perform primary anastomosis.