Exploring 6  years of colorectal cancer surgery in rural Italy: insights from 648 consecutive patients unveiling successes and challenges

AbstractThe multidisciplinary management of patients suffering from colorectal cancer (CRC) has significantly increased survival over the decades and surgery remains the only potentially curative option for it. However, despite the implementation of minimally invasive surgery and ERAS pathway, the overall morbidity and mortality remain quite high, especially in rural populations because of urban  − rural disparities. The aim of the study is to analyze the characteristics and the surgical outcomes of a series of unselected CRC patients residing in two similar rural areas in Italy. A total of 648 consecutive patients of a median age of 73 years (IQR 64–81) was enrolled between 2017 a nd 2022 in a prospective database. Emergency admission (EA) was recorded in 221 patients (34.1%), and emergency surgery (ES) was required in 11.4% of the patients. Tumor resection and laparoscopic resection rates were 95.0% and 63.2%, respectively. The median length of stay was 8 days. The overall morbidity and mortality rates were 23.5% and 3.2%, respectively. EA was associated with increased median age (77.5 vs. 71 ys,p <  0.001), increased mean ASA Score (2.84 vs. 2.59;p = 0.002) and increased IV stage disease rate (25.3% vs. 11.5%,p <  0.001). EA was also associated with lower tumor resection rate (87.3% vs. 99.1%,p <  0.001), restorative resection rate (71.5 vs. 89.7%,p <  0.001), and laparoscopic resection rate (36.2 vs. 72.6%,p <  0.001). Incr...
Source: Updates in Surgery - Category: Surgery Source Type: research