Ainul Hadi, Shehzad Akbar Khan, Zahid Aman, Mazhar Khan, Zafar Iqbal, Kamran Toryalay.
A two years experience with colorectal carcinoma.
J Med Sci Jan ;19(2):109-13.

Objective: To determine the frequency of colorectal malignancy and its management in our setup. Material and Methods: This is a prospective descriptive type of study and was conducted at Surgical Unit, Hayatabad Medical Complex, Peshawar from July 2007 to June 2009. In this study, a total of 63 cases of colorectal carcinoma were included which were admitted either through OPD as elective cases (40%) or in emergency (60%) with acute or subacute intestinal obstruction. Results: The mean age of patients at the time of presentation was 45.65 years and male to female ratio was 1.6:1. Left sided colon (including rectum) was affected in 77.78% (49 cases) of patients while in 22.22% (14 cases) patients, the right sided colon (including transverse colon) was involved. The rectum was involved in the highest number of cases (63.50%) and the descending colon in the lowest (03.17%). Intestinal obstruction was encountered in malignancy of the left sided colon (sigmoid colon 50%, descending colon 10%) followed by carcinoma rectum (25%) and caecum (15%). Depending upon the site and operability of tumours, operations performed included abdominoperineal resection in 18 patients (28.57%), anterior resection in 15 patients (23.81%), right hemicolectomy in 07 patients (11.11%), Hartmann’s procedure in 06 patients (09.52%), sigmoid colectomy in 05 patients (07.94%), transverse colectomy in 04 patients (06.35%), colostomy with biopsy in 03 patients (04.76%), left hemicolectomy (3.17%) and ileotransverse anastomosis with biopsy (3.17%) in 02 cases each, and ileostomy with biopsy in 01 patient (01.58%). Histology revealed adenocarcinoma in 95% of cases. Mean postoperative stay was 10 days. Operative mortality was 06.35% (04 cases). Forty five (71.43%) were followed up in OPD for 2 years. Local recurrence was 12.70% and 31 patients (49.21%) were disease free at the end of 2 years follow up. Conclusion: Bleeding per rectum and altered bowel habits are the main symptoms of colorectal carcinoma and should be thoroughly investigated. Particular importance should be given to patients below 40 years of age because colorectal carcinoma is also affecting the younger age group in our setup.

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