Aspectos clínicos e patológicos de pacientes com tumores colorretais diagnosticados durante cirurgia abdominal de urgência

• Autor(a) principal: SANTOS, Alex Caetano dos
• Data de Publicação: 2011
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFG
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tde/1732
• topic: Câncer colorretal; Tumor colorretal/obstrução; Tumor colorretal/perfuração; Neoplasia colorretal/urgência; Cólon-neoplasias-urgência; Tumor colorretal-perfuraç; Tumor colorretal-obstrução; Colorectal cancer; Colorectal tumor/obstruction; Colorectal tumor/perforation; Colorectal neoplasia/urgency; CNPQ::CIENCIAS DA SAUDE::MEDICINA

Context In 85% of the cases, colorectal cancer is diagnosed at an advanced stage during investigation of symptomatic patients. Currently, 10% to 33% of the cases may present emergency situations (obstruction or perforation), requiring immediate surgical treatment, and may result in higher mortality compared with elective surgical procedures. Objective Analyze clinical and pathological features of patients with colorectal cancer diagnosed during emergency abdominal surgery at the Hospital de Urgências de Goiânia. Methods We studied 107 patients operated on between January 2006 and June 2010 presenting with histologically confirmed colorectal malignancy. Results This series consisted of 58 women and 49 men with mean age of 59.81 ± 17.08 years. The most frequent symptoms were: abdominal pain (97.2%), no bowel movements (81.3%), vomiting (76.6%), and anorexia (40.2%). Clinical preoperative diagnosis was divided into five groups: obstructive acute abdomen (n = 68), obstructive acute perforation (n = 21), obstructive acute inflammation (n = 13), abdominal sepsis (n = 3), and severe gastrointestinal bleeding (n = 2). Tumors were located in the rectosigmoid (51.4%), transverse colon (19.6%), ascending colon (12.1%), descending colon (11.2%), and 5.6% of the cases presented association of two colon tumors (synchronic tumors). Histopathological examination revealed the presence of adenocarcinoma in 98.1% of the cases. The surgical treatments were: tumor resection with colostomy (85%), tumor resection with primary anastomosis (10.3%), and colostomy without tumor resection (4.7%). Immediate mortality occurred in 33.4% of the patients. Bivariate analysis of sex, tumor location and stage showed no relation to death (p > 0.05%). Conclusions Colorectal cancer in patients who underwent emergency surgery due to acute abdominal complication was more prevalent in females and elderly individuals with nonspecific colonic complaints. Adenocarcinoma of the rectosigmoid was the most frequent condition. Despite the high mortality rate, surgical treatment of colorectal cancer was indicated due to intestinal occlusion.