Colon cancer with perforation

• Published in: Surgery today (Tokyo, Japan) Vol. 49; no. 1; pp. 15 - 20
• Main Authors: Otani, Kensuke, Kawai, Kazushige, Hata, Keisuke, Tanaka, Toshiaki, Nishikawa, Takeshi, Sasaki, Kazuhito, Kaneko, Manabu, Murono, Koji, Emoto, Shigenobu, Nozawa, Hiroaki
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 2019
• Subjects: Colonic Neoplasms - complications; Colonic Neoplasms - mortality; Colonic Neoplasms - surgery; Digestive System Surgical Procedures - methods; Emergencies; Humans; Intestinal Perforation - etiology; Intestinal Perforation - mortality; Intestinal Perforation - surgery; Laparoscopy - methods; Medicine; Medicine & Public Health; Prognosis; Review Article; Surgery; Surgical Oncology; Perforation; Laparoscopic surgery; Colon cancer
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-018-1661-8

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.