Clinical outcome Analysis of immediate morbidity and mortality in patients presenting with obstructed Colorectal cancers.

Abstract

Abstract PURPOSE -The study aimed to identify immediate morbidity and mortality among patients presenting with obstructive colorectal cancers. Through this study, we also aim to determine the proportion of patients who have received a complete curative treatment after undergoing the emergency surgery and their key determinant of morbidity and mortality following emergency surgery, identify the histopathological subtype of the colorectal cancer METHODS-It is a Retrospective clinical analysis comprising a collective of consecutive colorectal cancer cases and analysis of CRC patients who came in obstructive Malignant colorectal cancer from 2013-2021 from a tertiary hospital throughout the past 8 years. The data collection from Christian Medical College, Ludhiana, India, data collection from the MRD (Medical Records Department)- search by keywords- “Rectal cancer” “Colonic cancer” “Intestinal obstruction” “Caecal growth” “Ascending colon /splenic flexure /descending colon cancer/Growth” “Malignant Large Bowel Obstruction”. RESULTS-140 patient files were screened of which 17 files were screened out due to non-matching of the inclusive criteria, of the 123 cases, patient data were analyzed, and a total of 36 patients matched the criteria of obstructed colon cancer, rest 87 cases were non obstructed colorectal malignancies. A main finding in the present study was that patients who underwent presented with obstructive CRC had significantly higher mortality and complication rates than patients who had non-obstructive symptoms, surgical site complication was the most important morbidity seen in patients who had undergone emergency surgery in the Obstructive group of CRC patients it was 25% and the p-value is 0.024, other complications like Anastomotic leak (2.78%)and Stomal hernia (2.78%) was also seen we found no statistical difference when compared with the non-obstructive CRC patients CONCLUSIONS-The present study demonstrates that obstructed colon cancer does present with increased morbidity, mortality, and hospital stay. It is therefore essential to consider and choose the most appropriate treatment option relying on preoperative prognostic factors such as age, co-morbidities, duration of symptoms, presentation of the patient, intra-operative findings, and above all the skill of the surgeons. Accurate preoperative evaluation of these prognostic factors might allow us to predict the clinical outcome and provides reliable assistance in surgical decision-making.