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Scripta Scientifica Medica

Challenges in surgical treatment of locally recurent colorectal carcinoma

Vesselin Marinov Marinov


Background. Locally  recurrent  CRC  is a disease  issuing an exceptional challenges to the surgeon. At the time of diagnosis local recurrences are often accompanied by complications and engage adjacent organs and anatomical structures. Local recurrences are often associated with systemic ones. Attempts to achieve a surgical radicality performing multivisceral resections in the surgical field of post-operative adhesions, adjuvant RT with neoangiogenesis and dissecting changed plans is often challenging.

Aim. To assess the early perioperative results of patients with locally recurrent CRC.

Material and method. A study based on 62 patients underwent surgery for locally recurrent CRC for a period of seven years  - January 2007 - December 2013. An early perioperative results are assessed.

Results. All patients in the group underwent surgery. We performed 26 palliative and 36 potentially curative surgical interventions. The  average  hospital stay is 9.2 days (7 -  22 days) . In one case  patient  died of multiple organ failure postoperatively.  Perioperative mortality rate was estimated at 1.6% and  perioperative morbidity was 25.8%(16 patients). 

Conclusion. Perianastomotic  recurrences without distant dissemination  are most favorable for radical surgical treatment. It is imperative that the implementation of en block resection without breaking the adherent to the tumor structures is important for achievement radicality.


local recurrence; colorectal; radical

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About The Author

Vesselin Marinov Marinov
"Tokuda Hospital Sofia" HPB Surgery dept.

HPB and General Surgery Clinic. Head of Miniinvasive and Laparoscopic Surgery.

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