[Management Of Obstructive Colorectal Cancer In Hospital Principal Of Dakar: A Report Of 37 Cases].

Purpose: The aim of this study was to describe the diagnostic and therapeutic aspects of the managment of obstructive colorectal cancer and to evaluate the different surgical methods.

Patients Et Methods: This retrospective, descriptive and analytical study was carry out from january 2008 to december 2014 in the visceral surgery department of Hospital Principal of Dakar and included 37 patients treated for obstructive colorectal cancer. The parameters studied were age, gender, unit of provenance, antecedents, clinical and paraclinical examination data, treatment and evolution. The data entered on Excel, was analyzed with SPSS software. Intergroup comparisons were made through Pearson or Fisher tests for qualitative values and Student or ANNOVA tests for quantitative values. The threshold of significance of the statistical tests was 5% in a bilateral situation.

Results: We collected 22 men and 15 women. CT scan showed the tumor in 23 cases. In 14 cases, the tumor was seen on laparotomy. The tumeur was in left colon in 28 cases, in right colon in 4 cases, in rectum in 5 cases. The right colon tumor underwent palliative surgery in 3 cases (1 ileostomy, 1 internal diversion, 1 caecostomy) and staged surgery in 1 case (caecostomy followed by secondary hemicolectomy). In left colon tumor were performed, 5 one stage left colectomies, 2 Hartmann procedures, 1 Bouilly Wolkmann, 3 internal diversions and 17 primary colostomies in which 12 had a secondary tumor resection. In rectum tumor was done 5 colostomies without secondary tumor resection. Twenty seven patients had their histology in wich 26 was adenocarcinoma. Nine patients underwent chemotherapy. The global early morbidity and mortality were respectively 35% and 13,5%. In left colon tumor, morbidity and mortality of the primary colostomy followed by secondary resection were respectively 17,6% and 11,7%. In case of emergent one stage tumor resection it was respectively 40% and 20%.Survival at one year was 43,2%.

Conclusion: Our results confirm the poor outcome of colorectal cancer obstruction and suggest that 2 stage tumor resection is safer in left colon cancer.