Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Surgery Today
Erschienen in: Surgery Today 1/2019

24.04.2018 | Review Article

Colon cancer with perforation

verfasst von: Kensuke Otani, Kazushige Kawai, Keisuke Hata, Toshiaki Tanaka, Takeshi Nishikawa, Kazuhito Sasaki, Manabu Kaneko, Koji Murono, Shigenobu Emoto, Hiroaki Nozawa

Erschienen in: Surgery Today | Ausgabe 1/2019

Einloggen, um Zugang zu erhalten

Abstract

Perforation of the colon is a rare complication for patients with colon cancer and usually requires emergent surgery. The characteristics of perforation differ based on the site of perforation, presenting as either perforation at the cancer site or perforation proximal to the cancer site. Peritonitis due to perforation tends to be more severe in cases of perforation proximal to the cancer site; however, the difference in the outcome between the two types remains unclear. Surgical treatment of colon cancer with perforation has changed over time. Recently, many reports have shown the safety and effectiveness of single-stage operation consisting of resection and primary anastomosis with intraoperative colonic lavage. Under certain conditions, laparoscopic surgery can be feasible and help minimize the invasion. However, emergent surgery for colon cancer with perforation is associated with a high rate of mortality and morbidity. The long-term prognosis seems to have no association with the existence of perforation. Oncologically curative resection may be warranted for perforated colon cancer. In this report, we perform a literature review and investigate the characteristics and surgical strategy for colon cancer with perforation.
Literatur
1.
Shinkawa H, Yasuhara H, Naka S, Yanagie H, Nojiri T, Furuya Y, et al. Factors affecting the early mortality of patients with nontraumatic colorectal perforation. Surg Today. 2003;33(1):13–7.CrossRef
2.
Crowder VH Jr, Cohn I Jr. Perforation in cancer of the colon and rectum. Dis Colon Rectum. 1967;10(6):415–20.CrossRef
3.
Kelley WE Jr, Brown PW, Lawrence W Jr, Terz JJ. Penetrating, obstructing, and perforating carcinomas of the colon and rectum. Arch Surg. 1981;116(4):381–4.CrossRef
4.
Kriwanek S, Armbruster C, Beckerhinn P, Dittrich K. Prognostic factors for survival in colonic perforation. Int J Colorectal Dis. 1994;9(3):158–62.CrossRef
5.
Mandava N, Kumar S, Pizzi WF, Aprile IJ. Perforated colorectal carcinomas. Am J Surg. 1996;172(3):236–8.CrossRef
6.
Chen HS, Sheen-Chen SM. Obstruction and perforation in colorectal adenocarcinoma: an analysis of prognosis and current trends. Surgery. 2000;127(4):370–6.CrossRef
7.
Tan KK, Hong CC, Zhang J, Liu JZ, Sim R. Surgery for perforated colorectal malignancy in an Asian population: an institution’s experience over 5 years. Int J Colorectal Dis. 2010;25(8):989–95.CrossRef
8.
Tan KK, Hong CC, Zhang J, Liu JZ, Sim R. Predictors of outcome following surgery in colonic perforation: an institution’s experience over 6 years. J Gastrointest Surg. 2011;15(2):277–84.CrossRef
9.
Kyllonen LE. Obstruction and perforation complicating colorectal carcinoma. An epidemiologic and clinical study with special reference to incidence and survival. Acta Chir Scand. 1987;153(10):607–14.PubMed
10.
Runkel NS, Schlag P, Schwarz V, Herfarth C. Outcome after emergency surgery for cancer of the large intestine. Br J Surg. 1991;78(2):183–8.CrossRef
11.
Kriwanek S, Armbruster C, Dittrich K, Beckerhinn P. Perforated colorectal cancer. Dis Colon Rectum. 1996;39(12):1409–14.CrossRef
12.
Tobaruela E, Camunas J, Enriquez-Navascues JM, Diez M, Ratia T, Martin A, et al. Medical factors in the morbidity and mortality associated with emergency colorectal cancer surgery. Rev Esp Enferm Dig. 1997;89(1):13–22.PubMed
13.
Umpleby HC, Williamson RC. Survival in acute obstructing colorectal carcinoma. Dis Colon Rectum. 1984;27(5):299–304.CrossRef
14.
Bakker IS, Snijders HS, Grossmann I, Karsten TM, Havenga K, Wiggers T. High mortality rates after nonelective colon cancer resection: results of a national audit. Colorectal Dis. 2016;18(6):612–21.CrossRef
15.
Peloquin AB. Factors influencing survival with complete obstruction and free perforation of colorectal cancers. Dis Colon Rectum. 1975;18(1):11–21.CrossRef
16.
Anwar MA, D’Souza F, Coulter R, Memon B, Khan IM, Memon MA. Outcome of acutely perforated colorectal cancers: experience of a single district general hospital. Surg Oncol. 2006;15(2):91–6.CrossRef
17.
Carraro PG, Segala M, Orlotti C, Tiberio G. Outcome of large-bowel perforation in patients with colorectal cancer. Dis Colon Rectum. 1998;41(11):1421–6.CrossRef
18.
Khan S, Pawlak SE, Eggenberger JC, Lee CS, Szilagy EJ, Margolin DA. Acute colonic perforation associated with colorectal cancer. Am Surg. 2001;67(3):261–4.PubMed
19.
Alvarez JA, Baldonedo RF, Bear IG, Truan N, Pire G, Alvarez P. Presentation, treatment, and multivariate analysis of risk factors for obstructive and perforative colorectal carcinoma. Am J Surg. 2005;190(3):376–82.CrossRef
20.
Welch JP, Donaldson GA. Perforative carcinoma of colon and rectum. Ann Surg. 1974;180(5):734–40.CrossRef
21.
Goligher JC, Smiddy FG. The treatment of acute obstruction or perforation with carcinoma of the colon and rectum. Br J Surg. 1957;45(191):270–4.CrossRef
22.
Glenn F, McSherry CK. Obstruction and perforation in colo-rectal cancer. Ann Surg. 1971;173(6):983–92.CrossRef
23.
Mealy K, Salman A, Arthur G. Definitive one-stage emergency large bowel surgery. Br J Surg. 1988;75(12):1216–9.CrossRef
24.
Fielding LP, Stewart-Brown S, Blesovsky L. Large-bowel obstruction caused by cancer: a prospective study. Br Med J. 1979;2(6189):515–7.CrossRef
25.
Buechter KJ, Boustany C, Caillouette R, Cohn I Jr. Surgical management of the acutely obstructed colon. A review of 127 cases. Am J Surg. 1988;156(3 Pt 1):163–8.CrossRef
26.
Runkel NS, Hinz U, Lehnert T, Buhr HJ, Herfarth C. Improved outcome after emergency surgery for cancer of the large intestine. Br J Surg. 1998;85(9):1260–5.CrossRef
27.
Mulherin JL Jr, Sawyers JL. Evaluation of three methods for managing penetrating colon injuries. J Trauma. 1975;15(7):580–7.CrossRef
28.
Sasaki LS, Allaben RD, Golwala R, Mittal VK. Primary repair of colon injuries: a prospective randomized study. J Trauma. 1995;39(5):895–901.CrossRef
29.
Maddern GJ, Nejjari Y, Dennison A, Siriser F, Bardoxaglou E, Launois B. Primary anastomosis with transverse colostomy as an alternative to Hartmann’s procedure. Br J Surg. 1995;82(2):170–1.CrossRef
30.
Wedell J, Banzhaf G, Chaoui R, Fischer R, Reichmann J. Surgical management of complicated colonic diverticulitis. Br J Surg. 1997;84(3):380–3.CrossRef
31.
Elliott TB, Yego S, Irvin TT. Five-year audit of the acute complications of diverticular disease. Br J Surg. 1997;84(4):535–9.CrossRef
32.
Biondo S, Jaurrieta E, Jorba R, Moreno P, Farran L, Borobia F, et al. Intraoperative colonic lavage and primary anastomosis in peritonitis and obstruction. Br J Surg. 1997;84(2):222–5.CrossRef
33.
Zorcolo L, Covotta L, Carlomagno N, Bartolo DC. Safety of primary anastomosis in emergency colo-rectal surgery. Colorectal Dis. 2003;5(3):262–9.CrossRef
34.
Gonzalez R, Smith CD, Ritter EM, Mason E, Duncan T, Ramshaw BJ. Laparoscopic palliative surgery for complicated colorectal cancer. Surg Endosc. 2005;19(1):43–6CrossRef
35.
Breitenstein S, Kraus A, Hahnloser D, Decurtins M, Clavien PA, Demartines N. Emergency left colon resection for acute perforation: primary anastomosis or Hartmann’s procedure? A case-matched control study. World J Surg. 2007;31(11):2117–24.CrossRef
36.
Radcliffe AG, Dudley HA. Intraoperative antegrade irrigation of the large intestine. Surg Gynecol Obstet. 1983;156(6):721–3.PubMed
37.
Murray JJ. Nonelective colon resection. Alternatives to multistage resections. Surg Clin North Am. 1991;71(6):1187–94.CrossRef
38.
Tan SG, Nambiar R, Rauff A, Ngoi SS, Goh HS. Primary resection and anastomosis in obstructed descending colon due to cancer. Arch Surg. 1991;126(6):748–51.CrossRef
39.
Arnaud JP, Bergamaschi R. Emergency subtotal/total colectomy with anastomosis for acutely obstructed carcinoma of the left colon. Dis Colon Rectum. 1994;37(7):685–8.CrossRef
40.
Deans GT, Krukowski ZH, Irwin ST. Malignant obstruction of the left colon. Br J Surg. 1994;81(9):1270–6.CrossRef
41.
Duraker N, Bender O, Memisoglu K, Yalciner A. Intraoperative bowel irrigation improves anastomotic collagen metabolism in the left-sided colonic obstruction but not covering colostomy. Int J Colorectal Dis. 1998;13(5–6):232–4.CrossRef
42.
Park UC, Chung SS, Kim KR, Seong MK, Yoon WH, Kim YJ, et al. Single-stage procedure with intraoperative colonoscopy and colonic irrigation in patients with obstructing left-sided colonic cancer. Int J Colorectal Dis. 2004;19(5):487–92.CrossRef
43.
Kim J, Lee GJ, Baek JH, Lee WS. Comparison of the surgical outcomes of laparoscopic versus open surgery for colon perforation during colonoscopy. Ann Surg Treat Res. 2014;87(3):139–43.CrossRef
44.
Lee IK, Sung NY, Lee YS, Lee SC, Kang WK, Cho HM, et al. The survival rate and prognostic factors in 26 perforated colorectal cancer patients. Int J Colorectal Dis. 2007;22(5):467–73.CrossRef
45.
Zhong W, Qiu C, Liu C, Fang C, Xia L, Liang J, et al. Efficacy of Laparoscopic Primary Repair in the Treatment of Colonic Perforation After Colonoscopy: A Review of 40,127 Patients. Surg Laparosc Endosc Percutan Tech. 2016;26(6):e105-e108.PubMed
46.
Coimbra C, Bouffioux L, Kohnen L, Deroover A, Dresse D, Denoel A, et al. Laparoscopic repair of colonoscopic perforation: a new standard? Surg Endosc. 2011;25(5):1514–7.CrossRef
47.
Anania G, Vedana L, Santini M, Scagliarini L, Giaccari S, Resta G, et al. Complications of diverticular disease: surgical laparoscopic treatment. G Chir. 2014;35(5–6):126–8.PubMedPubMedCentral
48.
De Magistris L, Azagra JS, Goergen M, De Blasi V, Arru L, Facy O. Laparoscopic sigmoidectomy in moderate and severe diverticulitis: analysis of short-term outcomes in a continuous series of 121 patients. Surg Endosc. 2013;27(5):1766–71.CrossRef
49.
Vennix S, Boersema GS, Buskens CJ, Menon AG, Tanis PJ, Lange JF, et al. Emergency laparoscopic sigmoidectomy for perforated diverticulitis with generalised peritonitis: a systematic review. Dig Surg. 2016;33(1):1–7.CrossRef
50.
Vennix S, Lips DJ, Di Saverio S, van Wagensveld BA, Brokelman WJ, Gerhards MF, et al. Acute laparoscopic and open sigmoidectomy for perforated diverticulitis: a propensity score-matched cohort. Surg Endosc. 2016;30(9):3889–96.CrossRef
51.
Biondo S, Kreisler E, Millan M, Fraccalvieri D, Golda T, Marti Rague J, et al. Differences in patient postoperative and long-term outcomes between obstructive and perforated colonic cancer. Am J Surg. 2008;195(4):427–32CrossRef
52.
Willett C, Tepper JE, Cohen A, Orlow E, Welch C. Obstructive and perforative colonic carcinoma: patterns of failure. J Clin Oncol. 1985;3(3):379–84.CrossRef
53.
Obrand DI, Gordon PH. Incidence and patterns of recurrence following curative resection for colorectal carcinoma. Dis Colon Rectum. 1997;40(1):15–24.CrossRef
54.
Asano H, Kojima K, Ogino N, Fukano H, Ohara Y, Shinozuka N. Postoperative recurrence and risk factors of colorectal cancer perforation. Int J Colorectal Dis. 2017;32(3):419–24.CrossRef
55.
Steinberg SM, Barkin JS, Kaplan RS, Stablein DM. Prognostic indicators of colon tumors. The Gastrointestinal Tumor Study Group experience. Cancer. 1986;57(9):1866–70.CrossRef
56.
Daniels M, Merkel S, Agaimy A, Hohenberger W. Treatment of perforated colon carcinomas—outcomes of radical surgery. Int J Colorectal Dis. 2015;30(11):1505–13.CrossRef
57.
Griffin MR, Bergstralh EJ, Coffey RJ, Beart RW Jr, Melton LJ. Predictors of survival after curative resection of carcinoma of the colon and rectum. Cancer. 1987;60(9):2318–24CrossRef
58.
Abdelrazeq AS, Scott N, Thorn C, Verbeke CS, Ambrose NS, Botterill ID, et al. The impact of spontaneous tumour perforation on outcome following colon cancer surgery. Colorectal Dis. 2008;10(8):775–80.CrossRef
59.
Cheynel N, Cortet M, Lepage C, Ortega-Debalon P, Faivre J, Bouvier AM. Incidence, patterns of failure, and prognosis of perforated colorectal cancers in a well-defined population. Dis Colon Rectum. 2009;52(3):406–11.CrossRef
60.
Biondo S, Ramos E, Deiros M, Rague JM, De Oca J, Moreno P, et al. Prognostic factors for mortality in left colonic peritonitis: a new scoring system. J Am Coll Surg. 2000;191(6):635–42.CrossRef
61.
Zielinski MD, Merchea A, Heller SF, You YN. Emergency management of perforated colon cancers: how aggressive should we be? J Gastrointest Surg. 2011;15(12):2232–8.CrossRef
62.
Benson AB, Schrag D, Somerfield MR, Cohen AM, Figueredo AT, Flynn PJ, et al. American Society of Clinical Oncology recommendations on adjuvant chemotherapy for stage II colon cancer. J Clin Oncol. 2004;22(16):3408–19.CrossRef
63.
Chen TM, Huang YT, Wang GC. Outcome of colon cancer initially presenting as colon perforation and obstruction. World J Surg Oncol. 2017;15(1):164.CrossRef
Metadaten
Titel
Colon cancer with perforation
verfasst von
Kensuke Otani
Kazushige Kawai
Keisuke Hata
Toshiaki Tanaka
Takeshi Nishikawa
Kazuhito Sasaki
Manabu Kaneko
Koji Murono
Shigenobu Emoto
Hiroaki Nozawa
Publikationsdatum
24.04.2018
Verlag
Springer Singapore
Erschienen in
Surgery Today / Ausgabe 1/2019
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-018-1661-8

Weitere Artikel der Ausgabe 1/2019

Surgery Today 1/2019 Zur Ausgabe

Original Article

Prognostic factors for cytology-positive gastric cancer

Original Article

Meaning of C-reactive protein around esophagectomy for cStage III esophageal cancer

Acknowledgment

Acknowledgment to reviewers

Original Article

Is neoadjuvant chemotherapy appropriate for patients with resectable liver metastases from colorectal cancer?

Original Article

Evaluating the quality of data from the Japanese National Clinical Database 2011 via a comparison with regional government report data and medical charts

Original Article

Functional evaluations comparing the double-tract method and the jejunal interposition method following laparoscopic proximal gastrectomy for gastric cancer: an investigation including laparoscopic total gastrectomy

Neu im Fachgebiet Chirurgie

23.04.2024 | Ablationstherapie | Nachrichten

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 | Appendizitis | Nachrichten

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 | Operationsvorbereitung | Nachrichten

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

19.04.2024 | EAU 2024 | Kongressbericht | Nachrichten

Ureterstriktur: Innovative OP-Technik bewährt sich
weitere anzeigen

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.