Intestinal obstruction is the most frequent complication in patients with colorectal carcinoma. In most large series, it has been reported to occur in 7% to 29% of patients. There were 385 patients admitted to the Taegu Fatima Hospital with
colorectal
carcinoma during the 10-year period from 1982 to 1991. Or this group, 45 patients(11.7%) had complete intestinal obstruction.
In the 45 patients with obstructing colorectal carcinoma there was no difference in sexual incidence and the peak age incidence was 40 to 49 years. The presenting symptoms and signs were similar to those of usual intestinal obstruction but weight
loss
and palpable abdominal mass were noted in 35.6% and 17.8%, respectively. Within the abdominal colon, the incidence of the colon most frequently involved were the sigmoid(33.3%) and rectum(20%).
The curative resection was possible in 26 patients(57.7%) of 43 who had operative managements. Of the 26 patients 22 had a primary resection and 4 had a staged procedure. In the primary rsection group of 22 patients 12 patients were employed
primary
end-to-end anastomosis and the remaining a proximal colostomy. Histo ogically, the carcinomas were adenocarcinoma in 95% of the patients with availabel histologic informations and there revealed fewer Dukes' A and more Dukes' C and D.
Postoperative
complications occurred in 32.5% and wound infection was the most common one. There were five postoperative fatality(11.6%) in the 43 patients operated upon. Follow-up study for patients eligible for 5 year survival was possible in 16 patients, of
whom 5
survived more than 3 years and 2 survived more than 5 years, a 5-year survival rate of 12.5%.
The choice of treatment for obstructing colorectal carcinoma is still debatable. But recently, an increasing number of investigators favor primary resection for the obstructing colorectal carcinoma even on the left-sided lesion. Our results
support
that
primary resection with proximal colostomy is an ideal procedure if performed selectively. It was concluded that patients with obstructing carcinoma of the colon and rectum have low curability and survival rates because of advanced disease.
Improvement
in survival statistics can be achieved by early diagnosis and treatment of the colorectal cancer before the onset of obstruction.
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