Abstract

Introduction: Stercoral peritonitis (SP) caused by perforation of the colon due to colorectal carcinoma (CRC) represents one of the most difficult types of peritoneal inflammation with complex clinical presentation. Aim of the study was to establish frequency of CRC as a cause of stercoral peritonitis, type of treatment, postoperative complications, length of hospital stay and mortality among our patients. Methods: Retrospectively we have analyzed two groups of patients. Group A: patients treated in period from 01.01.2001 to 31.12.2006, and group B consisted of patients treated from 01.01. 1995 to 31.12.2001. Surgical approach was different in those groups since we have accepted new strategies in the treatment of colonic perforations caused by CRC from the year 2000. Results: In group A we have operated 56 patients, median age 62.9, in most of the cases (35.71%) SP was caused by carcinoma of the left colon. In group B, we operated 65 patients, median age 60.5, most of SP also cased by the cancer of the left colon (38.46%). In both groups, there was similar number of minor complications (wound infection, peristomal abscess, personal irritation of the skin, stomal necrosis) 34 in group A and 39 in group B. This was not the case for major complication were in group A we recorded 30 different major complications (wound dehiscence, anastomotic leakage, intraabdominal abscess, fistula formation, and stomal retraction) opposed to 63 in group B. The higher percentage of complications in group B reflected to higher mortality rate (60%), opposed to mortality rate of 30% in group A. Conclusion: Following new strategies in the treatment of stercoral peritonitis caused by CRC in recent years, we have managed to reduce rate of postoperative complications and mortality as well as hospital stay among these patients.