Oberoi Ajit Singh, Peters Paul A, Muscat Neil, Alam Imran, Selvasekar Chelliah R
Surgery, Queen Elizabeth University Hospital, Glasgow, GBR.
General Surgery, Royal Albert Edward Infirmary, Wigan, GBR.
Cureus. 2025 Apr 1;17(4):e81591. doi: 10.7759/cureus.81591. eCollection 2025 Apr.
Introduction Many patients in Greater Manchester underwent emergency/urgent surgery, but limited data are available about managing these patients and their outcomes. We aimed to study the clinico-demographic profile, management trends, and outcomes of the patients presenting to the ED in the real world. Methods All patients with lower GI cancer (known or newly diagnosed on the present visit) in the ED requiring admission under surgeons for treatment were identified prospectively over six months and were included in the study. Results Nineteen patients were admitted (13 (69%) colon, 5 (26%) rectum, 1 (5%) anal cancer), with a median age of 67 years, and 10 (52.6%) were female. Ten (53%) patients were on the two-week wait pathway, and 14 (73.6%) patients presented with obstruction symptoms. Only 3 (15.7%) patients had received neoadjuvant therapy. Most had moderately differentiated adenocarcinoma. All had CT of the abdomen on admission, with 9 (52.6%) having CT of the thorax. All had locally advanced or metastatic cancers. Twelve (63%) patients underwent surgery (6 (50%) definitive, 6 (50%) diversion stoma). Nine (75%) patients had early postoperative complications, and 6 (50%) required ICU admission. The median postoperative stay was 9.5 days, with a 30-day mortality rate of 25%. Conclusion This study provides a snapshot of the management and outcomes of patients presenting in emergencies. A further study at the regional/national level is needed to investigate the increasing emergency presentations of colorectal cancer (CRC) despite an established screening program.
大曼彻斯特地区的许多患者接受了急诊/紧急手术，但关于这些患者的管理及其预后的数据有限。我们旨在研究现实世界中到急诊科就诊的患者的临床人口统计学特征、管理趋势和预后。方法：前瞻性地确定了六个月内在急诊科需要外科医生收治进行治疗的所有下消化道癌症患者（本次就诊已知或新诊断），并将其纳入研究。结果：19名患者入院（13例（69%）为结肠癌，5例（26%）为直肠癌，1例（5%）为肛管癌），中位年龄67岁，10例（52.6%）为女性。10例（53%）患者走的是两周等待路径，14例（73.6%）患者表现为梗阻症状。仅有3例（15.7%）患者接受了新辅助治疗。大多数为中分化腺癌。所有患者入院时均进行了腹部CT检查，9例（52.6%）进行了胸部CT检查。所有患者均为局部晚期或转移性癌症。12例（63%）患者接受了手术（6例（50%）为根治性手术，6例（50%）为造口转流术）。9例（75%）患者术后早期出现并发症，6例（50%）需要入住重症监护病房。术后中位住院时间为9.5天，30天死亡率为25%。结论：本研究提供了急诊患者管理及预后的概况。尽管有既定的筛查计划，但仍需在地区/国家层面进行进一步研究，以调查结直肠癌（CRC）急诊就诊人数不断增加的情况。
