Malignant Large Bowel Obstruction : Our Experience at A Tertiary Care Centre

Abstract

Background: Colorectal cancer is commonly diagnosed malignancy presenting either in obstruction or without obstruction. Malignant Large Bowel obstruction (MLBO) is usually a complication of advanced colorectal cancers, greatly reducing quality of life. We aimed to study the clinicopathological characteristics and outcomes of this group of patients requiring emergency intervention.

Materials & Methods: In our Observational study, Patients with Colorectal carcinomas presenting as large bowel obstruction were included in our study and followed-up. These MLBO patients were divided into two groups on the basis of their presentation & site of lesion: the Colonic Group & Rectal Group and were studied.

Results: A total of 78 patients of MLBO with known modes of presentation between 2015 & 2019 were included; 44 Colonic, and 34 Rectal Carcinomas with 71 being completely obstructive ones and 7 presenting as perforation peritonitis. The clinicopathological and tumour characteristics were noted. Our study showed a higher incidence of recurrence in the Rectal group as compared to the Colonic group with local recurrence being more common. A higher proportion of R0 Resection with better lymph node retrieval was noted in the Colonic Group. Overall 5- 5-year survival rates were slightly better in the Colonic group but not statistically significant. Immediate Post-op Complications were comparable.

Conclusion: Our study highlighted the various clinicopathological characteristics and observed outcomes of colorectal carcinoma patients presenting with large bowel obstruction. We found that MLBO presents as a challenging complication of advanced colorectal carcinomas, significantly impacting patients’ quality of life with slightly better outcomes in the colonic group of patients who had completed multi-modal therapy.