OBSTRUCTIVE COLORECTAL CANCER IN ELDERLY PATIENTS

Obstruction is the complication most frequently associated with colorectal cancer and it is also the main reason why these patients are admitted to hospital in an emergency. Taking into account the various comorbidities of elderly patients, an occlusive intestinal syndrome, caused by an obstructive colorectal tumor, presents a vital risk, which is why the main objective of the physician to decompress the obstruction. The aim of this study is to evaluate the obstructive colorectal cancer on elderly patients. MATERIAL AND METHOD: All the patients operated for obstructive colorectal cancer during one year (January1st 2008 until December 31st 2008), were retrospectively analyzed. Demographic, clinical, operative and postoperative data were analyzed. RESULTS: From 136 patients operated for obstructive colorectal cancer, 52 (38.12%) were over 60 years old and were included in the study. The mean age was 68.6±7.21 years old and men to women ratio was 1.2. Comorbidities were noted in 89.7%. Most of the tumors were located on the left colon (53.8%, n=28); in 7 cases (13.46%) the tumor was located on the right colon, and in 17 cases (32.7%) on the rectum and rectosigmoidian hunction. Different surgical procedures were perfomed according to tumor site and stage and patient’s general condition. So, in 39 patients a single step procedure was performed [sigmoidectomy (17.94%, n=7); right colectomy (12.82%, n=5); left colectomy (2.56%, n=1); rectosigmoidian resection (17.94%, n=7); internal derivation (10.25%, n=4), definitive colostomy (41.02%, n=16)] and in the other 13 patients, seriate procedure were performed [ileostomy followed by right colectomy (7.69%, n=1); colostomiy followed by left colectomy (23.07%, n=3), Hartmann operation (69.29%, n=9)). The postoperative morbidity was 19.23% with 3 cases of anastomotic leaks (5.79%). The 30 days mortality rate was nul. CONCLUSIONS: The intestinal obstruction is the most frequent presentation of colorectal cancer in elderly patients. The surgical procedure has to be tailored according to tumor site and stage and patient’s general condition