A CLINICAL STUDY OF CARCINOMA COLON IN UPPER ASSAM WITH SPECIAL REFERENCE TO ITS MANAGEMENT AND SHORT TERM COMPLICATIONS

Dr. Bijoyananda Das; Dr. Pawan Kumar Brij

Volume : IX, Issue : VIII, August - 2019

A CLINICAL STUDY OF CARCINOMA COLON IN UPPER ASSAM WITH SPECIAL REFERENCE TO ITS MANAGEMENT AND SHORT TERM COMPLICATIONS

Dr. Bijoyananda Das, Dr. Pawan Kumar Brij

Abstract :

Introduction: Colon cancer is the most common type of gastrointestinal cancer. It is a multifactorial disease process, with etiology encompassing genetic factors, environmental exposures (including diet), and inflammatory conditions of the digestive tract. Colon cancer may be of genetic, hereditary, familial and sporadic type. Risk factors for cancer of the colon include colonic polyps, long–standing ulcerative colitis, and genetic or family history. Most colorectal cancers develop from polyps. Removal of colon polyps can prevent colon cancer. Colon polyps and early colon cancer can have no symptoms. Therefore, regular screening is important, starting at age 50. This present study is to emphasize mode of clinical presentation and different treatment modalities of colon cancer in this area of country. Materials & Method:– The present study was a hospital based prospective study conducted in the Department of General Surgery, Assam Medical College & Hospital, Diugarh, during the one year period from June 2017 To May 2018. A total of 54 patients fulfilling the inclusion and exclusion criteria admitted in the General Surgical units of Assam Medical College & Hospital, Diugarh with carcinoma colon were included in this study. Patients who had taken Chemotherapy previously were excluded from the study. Results: In the present study series most of the cases were of age group 50–59 years. Out of 54 patients there were 29 male and 25 females with sex ratio of M : F=1.16:1. Most of the patients attended hospital after 1–6 month of initial symptoms i.e. 40 patients (70.07%) among which 5 patients presented with acute abdomen, presented within one month. Most common site of cancer growth was in sigmoid colon (33.33%), ascending colon 25.92%% and caecum accounted for 18.52% and only one case was found to be in splenic flexure. In the present study of 54 patients, 48 patients (88.88%) were operated. Among these 54 patients, growth was resectable in 31 patients (57.40%) and in 31.5% patients growth was unresectable so palliative operations were performed. 5 patients underwent emergency procedure and curative resection could not be performed because of the poor general condition of the patients. Every patient who was taken for surgry, prophylactic drain was placed. Post operative complications were encountered in 35 patients in the form of wound infection, wound dehiscence, Paralytic ileus, Colostomy retraction, Parastomal herniation, skin excoriation around colostomy, Pulmonary complication, Anastomotic leak and Sepsticemia. Conclusion: The present study shows that colon carcinoma is one of the common gastrointestinal malignancies in this region of the country. Most common age group affected was old age > 50 years with male predominance. Mostly presentation was late, who presented earlier presented with acute abdomen. Detailed history and physical examination with diagnostic investigations especially radiological and colonoscopy with tissue biopsy helped to obtain a definitive diagnosis. Most of the patients were non vegetarian by diet. Surgery was mainstay of treatment which was either curative or palliative according to site, stage and resectability. Postoperative complications were more in our study due to late stage presentation, poor general status of patients and poor patient compliance. Postoperative chemotherapy was given to all patients. Most of the patients were ignorant about the disease for which they could not turn up for follow up. Our hospital bases observational study has similar results with other studies in other parts of world with minimal differences. However, a study with long duration with follow up for long time is needed to obtain an exact incidence, risk factors associated mode of clinical presentation and post treatment status.