COLONIC CANCER

PRESENTATION AND MANAGEMENT IN A SURGICAL UNIT AT ALLIED HOSPITAL FAISALABAD

Abstract

A prospective study was conducted to see presentation and management of colonic
cancer presenting to a surgical unit in a teaching hospital at Faisalabad. Objectives: To know
different presenting symptomatology like abdominal mass, pain, intestinal obstruction, altered
bowel habits, rectal bleeding, age co-relation, sex distribution, anatomic location among colonic
cancer patients and management done for these patients. Study Design: A prospective study.
Period: February 2009 to March 2010 for one year. Material and Methods: Total 8 patients were
diagnosed and treated for colonic cancer presenting in a single surgical ward. Patients with age
above 14 years were included in study while patients presenting with trauma and metastatic
disease for other carcinoma were excluded. Results: Among 8 patients diagnosed for colonic
cancer, age’s range from 26 to 50 years at maximum, 2 patients (25 %) were males and 6 patients
(75 %) were females. Only one patient (12.5%) presented with single complaint of left iliac fossa
mass, 2 patients (25 %) with only single complaint of rectal bleeding as a presenting symptom
while all other 5 patients (62.5%) presented with more than one or two symptoms at the same
time. Among 5 patients presented with more than one symptom all had presented with abdominal
mass associated with additional symptoms like, one patient (12.5%) developed intestinal
obstruction with left sided abdominal mass, another one patient (12.5%) left sided abdominal
mass with alternate diarrhea and constipation, another one patient (12.5%) right sided mass
with pallor, one patient (12.5%) had constipation with left sided mass while another one patient
(12.5%) developed abdominal pain, weight loss and palpable left sided abdominal mass. Patients
were staged according to TNM staging system. All patients were above stage II and Dukes B. All
patients were operated in Surgical Unit II at Allied Hospital Faisalabad. Left hemi-colectomy was
done for 2 patients; right hemi-colectomy was done for single patient presented with mass and
anemia on right side, sigmoid resection with colostomy for one patient, Hartmann’s procedure
for another one patient and single stage resection with primary anastomosis for one patient. 2
patients underwent abdomino-perineal resection with end colostomy. Conclusion: This study
tells that majority of the patients with colon cancer presented with left sided abdominal mass and
other associated symptom, the age’s range from 26 to 50 years. Disease affected 6 females out of
total 8 patients. Two patients underwent APR with end colostomy while other patients were treated
with alternate procedures like primary anterior resection with anastomosis or end colostomy