Results of surgical treatment and prognosis of colonic neoplasms complicated by perforation

Abstract

Twenty two patients (13 males), whose ages ranged between 25 and 94 years, were subjected to surgical treatment for perforative carcinoma of the colon in a period of 10 years. Seventy three percent of tumors were localized in rectum and sigmoid colon. The perforation lied within the tumor in half of the patients and proximal to the tumor, specially in the cecum, in the rest. The perforation produced a local abscess in 5 patients and a diffuse peritonitis in 17 patients. Fifteen patients were subjected to segmental resections with a 40% operative mortality rate and 5 to a fecal diversion procedure with a 57% operative mortality. Tumor staging was similar to that of patients subjected to elective surgery. Crude 5 year survival was 18% and, excluding operative mortality, 57%.