Results of Surgery by Advanced Colorectal Carcinoma
Gatek J., Mica T. Dudesek B., Kohoutek M
Department of Surgery Atlas Hospital Zlin
Oncology Centrum Bata Hospital Zlin
Introduction
Assessment of results palliative surgery by advanced colorectal carcinoma, survival after
palliative surgery and survival with diverting colostomy.
Method
We included patients in stadium IV /T4, M / with colorectal carcinoma which was operated
at department of Surgery Atlas in Zlin from January 1st 1995 through December 31st 1999.
Results
There were 223 patients with colorectal carcinoma and from this group 58 in stadium IV
/T4,M1/ Mean age was 62,5 year.
Surgical techniques:
Resection of the colon or rectum:
Low anterior resection 23, right hemicolectomie 4, transverse colon resection 4,left
hemicolectomy 1, abdominoperineal amputation 4,
Enlarged surgical techniques:
Left hemicolectomy, stomach resection, splenectomy 1,low anterior rectal resection, urinary
bladder resection 3, low anterior rectal resection, hysterectomy 3, low anterior rectal
resection, ileostomy 1.
Anastomosis:
Ileo-transverso anastomosis 5, transverso-sigmo anastomosis 2.
Local surgical procedures 6. Diagnostic procedure only: Laporotomy 1, Laparoscopy 1.
Surgical procedures with colostomy:
Abdominoperineal amputation 4 / 2x for recurrence cancer/ Hartman 2,
diverting colostomy 6.
Survival rate for the group with surgery and postoperative chemotherapy or chemoradiation
therapy was 20 month and in the group with surgery and symptomatic therapy only was 14,7
month. Survival
rate with diverting colostomy was only 7,6 month.
Conclusion
Choice of appropriate surgical procedure for patients with colorectal cancer in stadium IV is
very
difficult decision to extend the patients life with good quality of life.