Background: Understanding of the biology of colorectal cancer and improvement in surgical techniques have led to significant improvements in the management of colorectal cancers and reduction of morbidity associated with it.Aim and Objective: Aim of the study was to know the effect of various factors like age, sex, physiological status, stage of disease, and type of resection on the outcome of intestinal obstruction due to colorectal cancer.Material and Methods: This study was conducted at Sher-i-Kashmir Institute of Medical Sciences Srinagar, Kashmir, India, both retrospectively and prospectively upon the patients who presented with intestinal obstruction due to colorectal cancer. A retrospective study was carried out from June 1989 to December 1999, while a prospective study was carried out from January 2000 to December 2001, with further follow-up for a period of 5 years.Results: A total of 97 patients of obstructing colorectal cancer were studied. The mean age of the patients was 48 years with a male female ratio of 1.3:1. Abdominal pain was the commonest symptom (92%) while abdominal distensionwas seen in 100% of patients. Sigmoid colon was the commonest site of lesion (26.80%) follow by splenic flexure (9.27%); 4.12% of our patients presented in Dukes stage A while 35.05% presented in stage D. Primary resection was done in 38 (39.20%) patients while staged resection was done in 25 (25.77%) patients; 24 patients died in the postoperative period during hospital stay giving an overall mortality of 24.74%. Only 56 patients could be followed for 5 complete years. Five-year survival was 23.12% as only 13 patients survived a period of 5 years. Survival was better among patients who underwent staged resection rather than primary resection. Introduction Colorectal carcinoma is one of the major health problems. About 57000 patients die of this disease in the United States every year (1). It is the third commonest cause of death in the United States and the second most common malignancy in the western countries. Although distributed worldwide, incidence is higher in industrialized and western countries, suggesting the possible influence of environment and genetics Dietary factors are found to be statistically associated with the risk of colorectal carcinoma Alcohol intake has also been linked with its development (2).Various predisposing factors for colorectal carcinoma include adenomatous polyps, familial adenomatous polyposis coli and hereditary non-polyposis coli cancer.Clinical presentation of colorectal carcinoma is influenced by size and location of tumors. Lesions of the right side tend to be bulky, ulcerating and present usually as anaemia, dull aching pain in the right lower quadrant and palpable mass in the same area. Lesions of the transverse colon usually present as obstruction or pain locally. A left side lesion is usually scirrhous, annular and presents as obstruction, alteration in the bowel habits and passage of blood or mucous mixed with bowel movement (2).Management of colorectal carcinoma depends upon the site of obstruction, state of disease and general condition of the patients. Right-side lesions are treated by resection and primary anastomosis without any diversion procedure (1). Left-side colonic lesions have been traditionally treated by a staged procedure which includes proximal decompression by stoma formation, resection and anastomosis followed by the closure of stoma. Nowadays, such staged procedure can be converted into a less staged procedure by the use of on-table colonic lavage. Re-establishment of lumen through the tumor using laser ablation or a stent placement allows decompression of bowel which can be followed by routine bowel preparation and then definitive resection. Lesions of sigmoid colon can also be managed by either Hartmann’s procedure or resection with end colostomy and mucous fistula or sigmoid resection with primary anastomosis with or without stoma. Obstructing carcinomas of the rect
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