Colorectal cancer presenting as surgical emergencies

Colorectal Cancer (CRC) is a major cause of cancer morbidity and mortality. Surgery is considered the first line therapy for CRC, and is generally encountered by many surgeons under elective conditions. Unfortunately, colorectal cancer may present acutely as a surgical emergency. These conditions include, but are not limited to perforation, hemorrhage, and obstruction. The presentation of a patient with these conditions can lead to higher morbidity and mortality. The choice of operation depends mainly on the site of the disease (left-sided versus right-sided), the patient's physical condition, nutritional status, and age. The treatment for right-sided lesions is a right hemicolectomy. However, treatment of left-sided lesions is still undecided. There are many therapeutic options such as primary or staged resections, Hartman's procedure, subtotal colectomy, or colostomy. Other therapies involve non-operative techniques such as laser therapy, colonic stenting, emergency endoscopy, and comfort measures. (C) 2004 Published by Elsevier Ltd.