Colorectal Cancer Surgical Emergency in Transplanted Patients
Colorectal cancer (CRC) is the third most common cancer worldwide with 1.4 million new cancer cases in 2012; it is the third most common cancer in men and second in women (Ferlay et al., Int J Cancer 136(5):E359–E386, 2015). The risk for developing CRC in patients after solid organ transplantation (SOT) is increased in comparison with general population. With growing numbers of transplantation worldwide, it is likely that a general surgeon will encounter a patient with graft-unrelated surgical problem, especially in emergency setting. Significant part of colorectal cancer patients has emergency presentation during the course of the disease; the acute condition can be an initial event that leads to the diagnosis of CRC, and it can also occur in later stages. When managing patients after SOT, several particularities must be considered as these patients have chronically decreased immune defense due to lifelong immunosuppressive therapy. In this population, the course of surgical emergency is associated with higher morbidity and mortality rates; therefore the decision of surgical treatment should not be delayed. However, oncological principles should be followed whenever feasible.
KeywordsColorectal cancer Solid organ transplantation Chronic immunosuppression Colorectal emergency Perioperative management
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