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Diseases of the Colon & Rectum

, Volume 33, Issue 10, pp 846–850 | Cite as

Palliative operations for colorectal cancer

  • J. Mäkelä
  • K. Haukipuro
  • S. Laitinen
  • M. I. Kairaluoma
Original Contributions

Abstract

A review of 96 consecutive patients who underwent palliative surgery for primary colorectal cancer was undertaken to clarify the value of palliation achieved with surgical treatment. The overall rate of postoperative mortality was 8 percent (8 of 96) and the overall rate of postoperative morbidity was 24 percent (23 of 96). The mortality rate was 5 percent (3 of 66) after resective surgery and 17 percent (5 of 30) after nonresective surgery. Three deaths were related to the malignant disease, three were related to the intra-abdominal infection, and two were related to formation of intestinocutaneous fistulas. Of the 8 patients who died, 1 had a tumor with local visceral involvement only and 7 had a tumor with more distant spread. Median survival was 10 months for all patients, 15 months for patients treated with resective surgery, and 7 months for nonresected patients. Five patients (5 percent) have survived for longer than 5 years. The median relief of preoperative cancer symptoms was 4 months (4 months after resective surgery and 1 month after nonresective surgery). Twenty-five patients have undergone second surgery. It is concluded that palliative resective surgery for colorectal cancer can improve patient comfort with an acceptable postoperative mortality rate when cancer growth is localized and in favorable cases with more distant spread, whereas nonresective surgery fails to achieve symptom relief.

Key words

Carcinoma Colorectal Palliative operative management 

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References

  1. 1.
    Umpleby HC, Williamson RC. Anastomotic recurrence in large bowel cancer. Br J Surg 1987;74:873–8.Google Scholar
  2. 2.
    Devesa JM, Morales V, Enriquez JM, et al. Colorectal cancer: the bases for a comprehensive follow-up. Dis Colon Rectum 1988;31:636–652.Google Scholar
  3. 3.
    Joffe J, Gordon PH. Palliative resection for colorectal cancer. Dis Colon Rectum 1981;24:355–60.Google Scholar
  4. 4.
    Cutler Sj, Ederer F. Maximum utilization of the life-table method in analyzing survival. J Chron Dis 1958;8:699–712.Google Scholar
  5. 5.
    Brown PW, Terz JJ, Lawrence W Jr, Bliervenicht SW. Survival after palliative surgery for advanced intraabdominal cancer. Am J Surg 1977;134:575–9.Google Scholar
  6. 6.
    Oxley E, Ellis H. Prognosis of cancer of the large bowel in the presence of liver metastases. Br J Surg 1969;56:149–52.Google Scholar
  7. 7.
    Nielsen J, Balslev I, Jensen HE. Carcinoma of the colon with liver metastases: operative indications and prognosis. Acta Chir Scand 1971;137:463–5.Google Scholar
  8. 8.
    Takaki HS, Ujiki GY, Shields TS. Palliative resection in the treatment of primary colorectal cancer. Am J Surg 1977;133:548–50.Google Scholar
  9. 9.
    Boey J, Choi TK, Wong J, Ong GB. Carcinoma of the colon and rectum with liver involvement. Surg Gynecol Obstet 1981;153:364–8.Google Scholar
  10. 10.
    Meguid MM, Debonis D, Mequid V, Hill LR, Terz JJ. Complications of abdominal operations for malignant disease. Am J Surg 1988;156:341–5.Google Scholar
  11. 11.
    Wanebo HJ, Semoglou C, Attiyeh F, Sterns MJ Jr. Surgical management of patients with primary operable colorectal cancer and synchronous liver metastases. Am J Surg 1978;135:81–4.Google Scholar
  12. 12.
    McDermott FT, Hughes ES, Pihl EA, et al. Changing survival prospects in rectal carcinoma: a series of 1306 patients managed by one surgeon. Dis Colon Rectum 1986;29:798–803.Google Scholar
  13. 13.
    Johnson WR, McDermott FT, Pihl E, Milne BJ, Price AB, Hughes ES. Palliative operative management in rectal carcinoma. Dis Colon Rectum 1981;24:606–9.Google Scholar
  14. 14.
    Moran MR, Rothenberger DA, Lahr CJ, Buls JG, Goldberg SM. Palliation for rectal cancer. Resection? Anastomosis? Arch Surg 1987;122:640–3.Google Scholar
  15. 15.
    Nilsson E, Gregersen N-P, Hartvik B, Sjödahl R. Carcinoma of the colon and rectum. Acta Chir Scand 1984;150:177–82.Google Scholar
  16. 16.
    Hsu S-D, Schwarze GN, Maxwell VL. Prolonged survival of a patient with advanced colonic cancer. Dis Colon Rectum 1981;24:636–8.Google Scholar
  17. 17.
    MÄkelÄ JT. Recurrent intra-abdominal cancer. Acta Universitatis Ouluensis, series D;1987:33.Google Scholar

Copyright information

© American Society of Colon and Rectal Surgeons 1990

Authors and Affiliations

  • J. Mäkelä
    • 1
  • K. Haukipuro
    • 1
  • S. Laitinen
    • 1
  • M. I. Kairaluoma
    • 1
  1. 1.Department of SurgeryOulu University Central HospitalOuluFinland

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