Presentation and Outcomes of Patients with Colorectal Malignancies Undergoing Emergency Surgery – Experience from a Tertiary Care Centre in India

Document Type : Research/Original Article

Authors

Post Graduate Institute of Medical Education and Research, Chandigarh

10.30476/acrr.2025.105365.1235

Abstract

 Background: Patients with colorectal cancer (CRC) presenting acutely to the emergency department vary in 
their physiological statuses and disease stages, necessitating a tailored surgical approach. This study assessed 
the presentation, surgical management, and perioperative outcomes of emergency CRC.
 Methods: A retrospective analysis was conducted on data collected from 44 patients presenting with acute 
CRC at the Postgraduate Institute of Medical Education and Research, Chandigarh, India, from January 2020 
to January 2022. Presentation, pathological, and surgical outcomes were assessed.
 Results: The mean age at presentation was 53.04±15.04 years (19-77). Intestinal obstruction was the most 
common presentation. A total of 24 colorectal resections (54.6%) were performed, along with 14 diversion 
colostomies (31.8%) and 6 diversion ileostomies (13.6%). The length of hospital stay (LOH) was 8.5±5.6 days, 
with a discharge rate of 77%. The 30-day mortality rate was 9.09%, and the readmission rate was 2.27%. A 
comparison of tumor resection versus non-resection procedures revealed statistically significant differences 
in mean age and LOH (P=0.019 and P=0.032, respectively). Tumor, Node, and Metastasis (TNM) staging was 
completed in 26 patients (56.5%); among them, 3 had stage I (11%), 8 had stage II (31%), 7 had stage III (27%), 
and 8 had stage IV (31%) disease. Among all patients, 23 (50%) had T3 disease, and 29 (63%) had moderately 
differentiated tumors. The median time to start adjuvant treatment was 3.5 months after surgery.
 Conclusion: This single-center retrospective study found that acute presentations of colorectal cancer in the 
emergency department were commonly associated with advanced-stage disease and significant physiological 
derangements. These factors presented considerable challenges to surgical approaches and perioperative 
management, potentially impacting long-term outcomes. Further studies are needed to assess the generalizability 
of these findings.

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