SURGICAL TREATMENT OPTIONS IN COMPLICATED COLO-RECTAL CANCERS OPERATED IN EMERGENCY
Globally, the colo-rectal cancer is the 4th in frequency of all neoplasia and in Romania is the 2nd, with a yearly tendency of increasing the number of new cases. The poor symptomatology in the inchoate stages and also the deficiency of effective screening programs lead to frequently late presentation of patients, with tumors in complicated stages, when the surgical operations, very often can no longer have a curative intention. We will present the results of a retrospective study during 10 years (2007-2016) that included 431 patients with complicated colo-rectal cancers, admitted and operated in the 2nd Surgery Clinic of the Clinical Emergency County Hospital “Sf. Ap. Andrei” from Galati, Romania. In 133 cases (30,9%), most of them occlusive, it was practiced in emergency a left iliac anus, leaving the tumor in its place. The Hartmann operation was practiced in 97 cases (22,5%). Anytime it was possible, we practiced operations with radical intentions, like: right hemicolectomy, in 46 cases (10,7%), left hemicolectomy, in 13 cases (3%), segmentary colectomy with anastomosis, in 30 cases (6,9%). Regarding the surgical operations in emergency, many of them don’t have a radical intention, taking into account the local invasion of the tumors and the metastasis. In these situations, a first surgical gesture is required, as an intervention that is meant to save the patient’s life, solving only the complication.