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.

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
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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