A CLINICAL STUDY OF RECTAL MALIGNANCY

Abstract

Janni Laxman

BACKGROUND Colorectal cancer is the fourth most common cancer in men and third most common cancer in women worldwide. Although distributed worldwide, the incidence is higher in industrialized and western countries. The rising trend in incidence and mortality from colorectal cancer is more striking in affluent than in poorer societies and differs substantially among ethnic groups. Due to significant development in the treatment of rectal malignancy, early and accurate detection of cases with thorough clinical and laboratory investigations will help to reduce mortality and morbidity of patients. MATERIALS AND METHODS It is a Cross Sectional Study conducted in the Department of Surgery, GEMS, Srikakulam. Duration of study was from July 2013 to July 2016. Inclusion Criteria- All patients with provisional diagnosis as rectal malignancies attending King George Hospital, Andhra Medical College, Visakhapatnam and patients above 18 yrs. Exclusion Criteria- Patients below 18 yrs. and patients with bleeding from rectum due to benign polyps, benign ulcers, inflammatory bowel disease, diverticulosis. RESULTS Among 50 Rectal malignancy cases, 38 (76%) were presented with bleeding rectum followed by 20 (40%) altered bowel habits, 12 (24%) showed pain abdomen, 8 (16%) presented with Obstruction, 6 (12%) presented with loss of appetite, and 6 (12%) presented with Weight loss. In our study bleeding per rectum was the most common complaint with which Rectal malignancy patients presented. 24 % underwent anterior resection, 36% underwent abdomino-perineal resection (APR), 16% underwent loop colostomy, 16% underwent neoadjuvant chemoradiation, 8% underwent palliative therapy. CONCLUSION Bleeding per rectum is the most frequent complaint with which rectal malignancy patients presented. The study also concludes that palpable rectal growth was found in 80% of patients and 72% presented in early stage of disease. Nearly 42% patients underwent abdominoperineal resection. Outcome of surgical treatment was normal in 60% and anastomotic leak in 10%, wound infection in 20%, stromal retraction in 2.5%, death is 7.5%.

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