Clin Colon Rectal Surg 2020; 33(05): 247-252
DOI: 10.1055/s-0040-1713741
Review Article

Perforated Colorectal Cancer

Authors

  • Alexios Tzivanakis

    1   Peritoneal Malignancy Institute, Basingstoke, Hampshire, United Kingdom
  • Brendan J. Moran

    1   Peritoneal Malignancy Institute, Basingstoke, Hampshire, United Kingdom

Abstract

The majority of patients with colorectal tumors will present via the elective route. However, one-fifth of patients will present as an emergency. The most common cause of emergency presentation of colorectal cancer is obstruction followed by perforation, and in many cases, patients will present with both. We discuss the management of the patient presenting with a perforated colorectal tumor covering the acute presentation and also how to deal with consequences of a perforated tumor, namely, the management of colorectal peritoneal metastasis (CPM). CPM used to be considered a terminal condition; however, a strategy of early detection of CPM, careful patient selection for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, leads to much improved outcomes and even cure, in some patient compared with systemic chemotherapy alone.



Publication History

Article published online:
20 July 2020

Thieme Medical Publishers
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