Abstract
Aim: Emergency complications of colon cancer including obstruction and perforation can be seen in up to one third of patients as an initial presentation. The aim of this study is to determine the rate of re-intervention, incidence of complications, and prognostic factors of emergency surgery in obstructing and perforated colon cancer. Methods: Data of patients with colorectal cancer managed in our hospital during a 5-year period were retrospectively analyzed. Only patients presented to the emergency department (ED) for a complicated colorectal cancer with obstruction or perforation and underwent a surgical intervention were included. Results: A total of 176 colon cancer patients with a mean age of 64.24 were included. Obstructing colon cancer was the most commonly presented complication (70%), followed by perforated colon cancer (17.5%). Around 42% were diagnosed prior to ED visit and 58%were diagnosed first in the ED at the time of complication. Fifty-two (30.6%) patients underwent a surgical re-intervention. In the univariate analysis, hospitalization duration and undergoing a surgical re-intervention were the most significant factors associated with post-operative complications (p=0.002). Additionally, patients who underwent laparotomy had almost 3 times higher risk for experiencing post-operative complications compared to those who underwent a laparoscopic approach, OR= 2.801, p=.018; (CI 95% 1.195-6.568). The mortality incidence is 13.5%. Conclusion: Rate of re intervention appears to be high and associated with increased mortality among patients with complicated colon cancer. Further studies are needed to determine the appropriate timing and indication for undergoing a surgical intervention after initial surgical management for complicated colon cancer.