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. The aim of the study was to establish the frequency of CRC as a cause of stercoral peritonitis, type of treatment, postoperative complicatins, length of hospital stay and mortality among our patients. Retrospectively, two groups of patients were analyzed. Group A - the patients treated in the period from January 1, 2001 to December 31, 2006, and group B - the patients treated from January 1, 1995 to December 31, 2001. Surgical approach was different in those groups since we have accepted new strategies in the treatment of colonic perforations caused by CRC from 2000. Group A included 56 operated patients, median age 62.9, and in most of the cases (35.71%) SP was caused by carcinoma of the left colon. Group B involved 65 operated patients, median age 60.5, where most of SP cases were also caused by the cancer of the left colon (38.46%). In both groups, there was a 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. Thirty different major complications were recorded in group A (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 affected higher mortality rate (60%), opposed to mortality rate of 30% in group A. By applying new strategies in the treatment of stercoral peritonitis caused by CRC in the recent years, we have managed to reduce the rate of postoperative complications and mortality as well as hospital stay among these patients.
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