Treatment Strategy for Perforated Colorectal Cancer

Abstract

In general, when perforating peritonitis is diagnosed, colorectal cancer is not very often determined to be the cause. If perforation of the lower gastrointestinal tract is suspected based on symptoms and abdominal findings, the patient's general condition should be assessed. After diagnosing colorectal cancer perforation, the site of perforation and degree of peritonitis/contamination should be determined, and then the treatment strategy should be decided based on these findings and the general condition of the patient. In recent years, although the survival rate has increased due to progress in intensive care management, the acute phase mortality rate in emergency surgery is still higher than that in elective colorectal surgery. On the other hand, if the patient's general condition is good and the patient is judged to be able to tolerate extensive surgery, radical surgery for cancer should be considered. Surgery that prioritizes life-saving for peritonitis and surgery that performs radical surgery including resection of multiple organs for cure of cancer require conflicting surgical strategies. It is necessary to consider the patient's background and general and intraoperative condition, and then perform the optimal surgical procedure that satisfies both surgical strategies.