Abstract
Thirty-nine cases of perforation of the large intestine were subjected to a retrospective study of the cause, site of perforation, clinical findings, prognosis, and operative results and prognosis of perforated colo-rectal cancer patients who were in the greatest frequency were discussed. Seventy four percent of them occurred in sigmoid colon and sigmoid segment of the rectum. These perforations were caused by colo-rectal cancer (38%) and diverticulum of large intestine (36%), namely, the both causes accounted for 74% of all cases. The appearance rate of intraperitoneal free air, which is an evidence for definitive diagnosis, was as low as 49%. Irrespective of causes of perforations, preoperative shock state, free perforation, and intraperitoneal coproplanesia were the risk factors for perforation of the large intestine. The mortality directly related to operation was 21%. Fifteen cases of perforation caused by colo-rectal cancer represented 2.1% of 717 cases operated on for colo-rectal cancer, and were predominantly comprised of advanced cases, in which curative resection rate was as low as 47% and 5-year survival rate in curative resectin cases was as poor as 34.3%. For such cases antishock treatments starting in a preoperative period is important. On the cases of perforated colo-rectal cancer patients, it should be considered to be resected in one staged with lymphnode dissection.
