Abstract
About 30% of colorectal cancer reveals itself acutely, representing a surgical emergency. Right colon cancers often present with acute bowel obstruction, followed by perforation and bleeding. Patients requiring emergency surgery have a poorer prognosis with higher morbidity and mortality rates compared to those treated in an elective setting; obstructive feature, especially, is reported to correlate with advanced stage at presentation and to be an independent high-risk feature of recurrence.
Treatment must be tailored on the specific patient based on age, comorbidities, physiological reservoir, nutritional status, and degree of autonomy.
Surgical treatment has two main goals: palliation of symptoms and oncological radicality.
The gold standard is a right hemicolectomy with ileocolic anastomosis, when feasible; a laparoscopic approach may be attempted in selected cases. The principles of damage control surgery (DCS) may be applied in case of hemodynamic instability. Other nonsurgical therapeutic options, like SEMS insertion, can be considered for high-risk and extremely frail patients.
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Strambi, S., Tartaglia, D., Cremonini, C., Musetti, S., Chiarugi, M., Coccolini, F. (2023). Right Colon. In: Tarasconi, A., Bui, S., Chirica, M., Roth, G., Nahmias, J. (eds) Oncologic Surgical Emergencies. Hot Topics in Acute Care Surgery and Trauma. Springer, Cham. https://doi.org/10.1007/978-3-031-36860-8_8
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