Emergency Surgery for Colon Cancer in the Aged

Abstract

The lower mortality rate following primary resection is achieved by preselection of patients. The preselection is such that patients in poor general condition who have tumors in advanced stages are not treated by resection. The significantly (P = .03) highest postoperative mortality rate in patients who underwent primary resection after tumor perforation reflects the necessity of resection in those cases regardless of higher comorbidity. In an emergency situation, initial minimal surgery followed by staged resection is a feasible alternative to treat aged patients with a higher comorbidity and an intraoperatively established greater spread of tumor. This procedure permits delayed radical resection at the lowest rate of clinical mortality for this age group and is especially suitable for frail, aged patients in poor condition. The advantages of staged resection can be demonstrated by the fact that more patients with a higher comorbidity survive. The poor physiological adaptability of elderly patients limits their ability to compensate for postoperative organ failure and adds the risk of comorbidity. Hence, these 2 factors are associated with poor prognosis in this age group.