What is it about?
What is the best treatment for patients admitted as emergencies for a complication of a colorectal cancer? Patients with bowel obstruction/bleeding/perforation caused by bowel cancer can either undergo immediate resection of the cancer or a staged treatment, with a "damage control procedure" in the emergency setting just to resolve the acute complication, followed by an elective resection of the cancer, where feasible, after the patient has been fully investigated and well prepared for the operation. Our study demonstrated that there is no significant difference between the two approaches and the choice will remain with the on-call surgeon and the patient. However, a staged approach would give the possibility to the patient to have a laparoscopic resection, which is known to improve short and possibly also long term outcomes in colorectal surgery.
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Why is it important?
Our article reports an international experience developed in two completely different settings: a UK district general hospital located on a small island in the middle of the Irish Sea and an Italian university hospital based in the very centre of Rome.
Perspectives
Although this paper gives very important indications, it is still a retrospective analysis. A proper large randomised control trial is needed to clarify the initial question about the best treatment for complicated colorectal cancers.
Giovanni Domenico Tebala
East Kent Hospitals University NHS Foundation Trust
Read the Original
This page is a summary of: Emergency treatment of complicated colorectal cancer, Cancer Management and Research, April 2018, Dove Medical Press,
DOI: 10.2147/cmar.s158335.
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