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Scripta Scientifica Medica

The place of palliative multivisceral resections for locally advanced colorectal cancer

Vesselin Marinov Marinov



Background. Performance of multivisceral resections in cases of locally and systematically advanced colorectal cancer have their own place in the treatment of this disease. This approach is used usually in young patients as a part of two-stage surgical strategy or combined with adjuvant chemotherapy to achieve re-staging  of systemic metastases. Avoiding colostomy and better quality of life is a strong suggestion in this direction.

Aim. To determine the indications and early postoperative results in group of patients with locally and systemically advanced colorectal cancer with multivisceral resection of local disease.

Material and method. For a period of 8 years 2007 - 2014, 27 patients underwent local multivisceral resection with distant metastases left. For the same period total 191 patients were operated for locally advanced CRC. All methods for early postoperative results assessment were used.

Results. The average age in the group was 64 years. Perioperative mortality rate is 3.7% and morbidity is 14,8%. In only 3 cases we preformed colostomy.

Conclusion. In selected patients aggressive surgical attempt is justified and connected with low mortality and morbidity rate. Quality of life is a strong suggestion for such therapeutic strategy.


palliative; colorectal; multivisceral

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Schmiegel W, Pox C, Adler G, Fleig W, Fölsch UR, Frühmorgen P, et al. S3-Guidelines "Conference Colorectal" Carcinoma 2004. Z Gastroenterol. 2004;42:1129-1177

Ruo L, Gougoutas C, Paty PB, Guillem JG, Cohen AM, Wong WD. Elective bowel resection for incurable stage IV colorectal cancer: prognostic variables for asymptomatic patients. J Am Coll Surg.2003;196:722-728.

Mella J, Biffin A, Radcliffe AG, Stamatakis JD, Steele RJ. Colorectal Cancer Working Group; Royal College of Surgeons of England Clinical Epidemiology and Audit Unit. Population-based audit of colorectal cancer management in two UK health regions. Br J Surg. 1997;84:1731-1736.

Mäkelä J, Haukipuro K, Laitinen S, Kairaluoma MI. Palliative operations for colorectal cancer. Dis Colon Rectum. 1990;33:846-850.

Liu SK, Church JM, Lavery IC, Fazio VW. Operation in patients with incurable colon cancer--is it worthwhile? Dis Colon Rectum. 1997;40:11-14.

Beham A, Rentsch M, Püllmann K, Mantouvalou L, Spatz H, Schlitt HJ, et al. Survival benefit in patients after palliative resection vs non-resection colon cancer surgery. World J Gastroenterol. 2006;12:6634-6638.

Guba M, Bosserhoff AK, Steinbauer M, Abels C, Anthuber M, Buettner R, et al. Overexpression of melanoma inhibitory activity (MIA) enhances extravasation and metastasis of A-mel 3 melanoma cells in vivo. Br J Cancer. 2000;83:1216-1222.

Costi R, Mazzeo A, Di Mauro D, Veronesi L, Sansebastiano G, Violi V, et al. Palliative resection of colorectal cancer: does it prolong survival? Ann Surg Oncol. 2007;14:2567-2576.

Kleespies A, Füessl KE, Seeliger H, Eichhorn ME, Müller MH, Rentsch M, et al. Determinants of morbidity and survival after elective non-curative resection of stage IV colon and rectal cancer. Int J Colorectal Dis. 2009;24:1097-1109.

Kim JH, Shon DH, Cahng BI, Chung MK, Shim MC. Complete single stage management of left colon cancer obstruction with a new devices. J Korean Soc Coloproctol. 2002;18:30-36.

Costi R, Di Mauro D, Giordano P, Leonardi F, Veronesi L, Sarli L, et al. Impact of palliative chemotherapy and surgery on management of stage IV incurable colorectal cancer. Ann Surg Oncol.2010;17:432-440.

Multivisceral `en-block` resections of colorectal tumors - milestones in the surgical techniques. K. Draganov, V. Marinov, A. Petreska, D. Rusenov, Y. Kolev, B. Borisov, N. Katev, D. Penchev, G. Chengalova, S. Lavchev, D. Stoyanova, S. Tonev, R. Gaydarski. Scripta Scientifica Medica, vol. 45 Suppl. 2, 2013, pp. 50-57

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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