Management and long-term outcome in obstructing colon cancer

Management of obstructing colorectal cancer (CRC) is complex and challenging. For long periods, emergency surgery has been the preferred treatment for right-sided OCC, as for left-sided OCC treatment strategies. In acute setting, morbidity and mortality are significantly higher than resection in a “elective” setting. Therefore, postponing resection to avoid emergency resection have gained attention. In recent years, more attention has been given to improve postoperative outcome in obstructing CRC. The short-term outcome for emergency surgery for left-sided obstructing CRC has been worse than for right-sided OCC. Therefore, treatment strategies improving short-term mortality and morbidity were mainly focused on left-sided OCC. This thesis addresses the long-term outcome in obstructing CRC. With a special interest to the impact of right-sided OCC for both short and long-term outcomes. In this thesis a management strategy for these patients is proposed to attempt clinical improvement by optimising preoperative care and preparation prior to surgery, especially in right sided OCC.