Malignant Colorectal Resections: A single centre experience

M A Gok, S J Ward, M M Sadat, U A Khan. Macclesfield District General Hospital

Introduction Colorectal Cancer (CRC) is the 3rd common cancer in the UK in men & women, accounting for 13% on new cancer cases in 2010 (incidence of 40695). Surgery in the main treatment & usually undertaken within 6 months of presentation. The aim of the study is to assess colorectal malignant resections at a single institution.

Materials & Methods This is a retrospective study carried out since January 2007 at Macclesfield District General Hospital. Descriptive demography, co-morbidities, histopathology and surgical outcomes were evaluated for all malignant colorectal resections.

Results
CRC resections (n=740)
Ages (yrs) (mean ± SE) 71.1 ± 0.4
Sex (M : F) 406 : 334
ASA (median) 2
Weight (kg) (mean ± SE) 73.9 ± 0.8
BMI (mean ± SE) 25.9 ± 0.2
Appendix / Ileum (n) 19
Caecum (n) 148
Ascending colon (n) 60
Transverse colon (n) 82
Descending colon (n) 22
Sigmoid (n) 157
Rectosigmoid (n) 40
Rectum (n) 212
Operation Time (min) (mean) 155.3 ± 2.6
Small bowel length (mm) 101.0 ± 5.2
Large bowel length (mm) 263.7 ± 13.4
LN harvest (median ± IQR) 14 ± 4
Diverticulosis (n) 161
IBD (n) 15
Synchronous tumours (n) 108
Ileostomy/colostomy 211
LOS (days) (median ± IQR) 9 + 3.5
Survival rates (1st, 3rd & 5th yrs) (%) 87.8%, 75.1%, 68.6%
Dukes A (1st, 3rd & 5th yrs) (%) 96.1%, 90.9%, 84.0%
Dukes B (1st 3rd & 5th yrs) (%) 90.8%, 83.5%, 79.2%
Dukes C (1st, 3rd & 5th yrs) (%) 82.5%, 61.2%, 53.8%

Discussion Left sided colon cancer represents almost 2/3 rds (58.2 %) of the CRC. There is predominance of CRC in men. Survival rates drop with progression of disease (Dukes / TNM classification). CRC cancer should be managed in the multi-disciplinary setting.

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