The Choice Of Surgical Management For Colorectal Carcinoma With Acute Obstruction In The Aged

Objective To analyze the clinical features and surgical management of colorectal carcinoma with acute obstruction in the aged.Methods This is a retrospective study including92elderly patients of acute obstruction result from colorectal carcinoma. All the patients underwent emergency operations. They were divided into groups according to different position of the tumor and different operations performed on them. There were39cases in group A with left-side colonic lesion, and one-stage resection and primary anastomosis was performed on them all. There were53cases in group B with left-side colonic or rectal lesion, and their condition were feasible. Palliative colostomy was performed in them.Result Postoperative complications occurred in23cases, including lung infection in10cases, anastomotic leakage in1cases, wound infection in9cases and abdominal cavity infection in3cases. There was no surgical death in the cases. There is significant difference between group A and group B according to incidence of postoperative complication, length of stay and total medical expenses;There is no significant difference between group A and group B according to incidence of recovery time of intestinal tract after operation.Conclusion Correct preoperative management is vital for elderly patients of acute obstruction result from colorectal and rectal carcinoma. Segmental resection with on-table lavage and primary anastomosis are feasible and safe in selected cases of obstruction result from left colorectal and rectal carcinoma. Decompression and decontamination by transanal ileus tube is an effective complement for one-stage resection and primary anastomosis.