Objective:Colon cancer patients presented with obstruction were known to have worse postoperative morbidity and mortality rates, but conflicting data has been reported in recent years. We aimed to investigate postoperative complication rates, and short and long-term oncological outcomes in patients with colon cancer treated with either emergency surgery due to obstruction or elective surgery.Methods:Two hundred fifty two patients were analyzed. Patients presented with obstruction and underwent an emergency surgery, and patients operated under elective circumstances were compared according to their demographic variables, tumor characteristics, and short and long term treatment outcomes.Results:Distribution of age, gender and comorbidities were similar between both the groups. Need for an end colostomy was significantly higher in obstructed patients (22.7% vs 1.6%, respectively). Obstructed patients were tending to be at an advanced stage. Postoperative morbidity and mortality, and prognosis of colon cancer patients presented with obstruction is worse than patients operated under elective circumstances.Conclusions:Colon cancer patients presented with obstruction constitutes more than one quarter of all patients. These patients have significantly higher morbidity and mortality rates. Obstructed colon cancer usually appears at advanced stage. Primary resection and anastomosis is safe in most of the cases.
Altmış üç yaşındaki erkek hasta karın ağrısı, kanlı dışkılama, bulantı ve kusma şikayetleri ile hastaneye müracaat etti. Yapılan muayene ve tetkiklerinde; bilgisayarlı tomografide intestinal intussusepsiyon ve karın içi lenf düğümleri saptandı. Kolonoskopik inceleme sonrası redüksiyon sağlanamadı. Laparotomide, çekuma invajine ince barsak segmentleri redükte olmaması üzerine sağ hemikolektomi ve palpasyonda ince barsakta lümen içi saptanan tümöral kitleleri içine alan 60 cm ince barsak segmenti rezeke edildi. Patolojik inceleme sonrasında kolonda 1 ve ince barsaklarda 8 toplamda 9 adet polipoid lezyon saptandı. Histolojik incelemede sitoplazmik melanin birikimi ile epiteloid ve iğsi tümör hücreleri izlendi. İmmünohistokimyasal boyamada tümör hücrelerinde S-100, HMB-45 ve melan-A pozitif olarak bulundu. Moleküler incelenmesi BRAF geni 15 Ekzonlar c.1799> a (p.v600 A) mutasyon saptanan hastanın malign melonom olarak rapor edilmesi sonrası hasta yeniden değerlendirildi ve göğüs ön duvarında deride malign melanom saptandı. Anahtar Kelimeler: İntussusepsiyon, metastaz, melanom ÖZ ABSTRACTA 63-year-old man presented to the emergency department with abdominal pain, episodes of bloody stool, nausea, and vomiting. Abdominal computed tomography showed lower intestinal intussusception and enlarged lymph nodes. Colonoscopic reduction was not possible. Exploratory laparotomy revealed a 15-cm mass comprised of the ileocecal region that had intussuscepted secondary to the small bowel. Palliative right hemicolectomy and resection of 60 cm segments of the small bowel were performed. Pathologic examination of the excised specimen revealed polypoid masses. There were 9 polyps, 1 in the ascending colon and the others in the ileum. Histopathological examination demonstrated obvious features of melanoma associated with epitheloid and spindle tumor cells and cytoplasmic melanin deposition. The tumor cells showed positivity for S-100, HMB-45 and Melan-A. Molecular examination revealed a c.1799> A (p.v600 A) mutation in exon 15 of the BRAF gene. The patient was re-examined and a nevus was found on the left anterior chest wall.
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