The Studies on the Colorectal Cancer by Degree of the Symptom of Bowel Obstruction

Kuniyuki Tsuchiya, Seishiro Inaba, Yuji Kondo, Kanzi Kawai, Atsuhiro Ogino, Tomoko Umeda, Yasuaki Ueda

Department of Surgery, National Nara Hospital

A total 213 patients with colorectal cancer invading beyond the muscularis propria were classified into 3 groups according to presence of symptoms of bowel obstruction. Patients were classed as Ileus 0 group when they had no symptoms of obstruction, Ileus 2 groups when they clinically had Ileus, and Ileus 1 group if they had symptoms intermediate between those in Ileus 0 and Ileus 2. There were 58 patients (27.2%) in the Ileus 1 group and 29 patients (13.6%) in the Ileus 2 group. There were no significant differences among the three groups with respect to age, sex, gross tumor appearance, tumor diameter, and histological type. The Ileus 0 group had significantly fewer of the following features: degrees of constriction in the lesion, circumferential cancer invasion, vertical invasion of the bowel wall, and liver metastasis. The stage was earlier in the Ileus 0 group. The degrees of constriction and the extent of circumferential involvement in the Ileus 2 group were higher than in the Ileus 1 group. These results suggest that the symptoms of obstruction chiefly caused by constriction of the lesion, circumferential cancer invasion and vertical cancer invasion. Because the survival rate of patients after curative operation in the Ileus 2 group was as good as that in the Ileus 0 group, it is worth trying the curative operation also in the patient with severe bowel obstruction.

Key words
bowel obstruction, colorectal cancer

Reprint requests
Kuniyuki Tsuchiya Department of Surgery, National Nara Hospital
1-50-1 Higashikideracho, Nara, 630 JAPAN

Accepted
September 4, 1991

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