SP 10.14 Oncological Outcomes of Emergency Versus Elective Colonic Resection for Colon Cancer: A Retrospective Audit Based on Guideline Compliance
Ashwin Abraham, Manoj Gowda, Ahmed Abdelrahim, Abdalla MustafaAbstract
Background
Emergency colonic resection for cancer is often associated with concerns regarding oncological adequacy compared with elective surgery. National and international guidelines, including ESMO and RCPATH, define standards for optimal surgical and histopathological outcomes, including R0 resection, adequate lymph node yield, and avoidance of conversion.
Aim
This study assessed whether emergency colonic resections for locally infiltrative colon cancer achieve satisfactory oncological outcomes in line with established guidelines and compared these outcomes with elective resections.
Methods
A retrospective audit compared emergency and elective colonic resections for cancer. Key outcome measures included R0 resection status, lymph node yield greater than 15, and absence of conversion. Compliance with guideline-recommended standards was assessed, and statistical comparisons were performed between groups.
Results
Emergency cases achieved an R0 resection rate of 96.97% compared with 100% in elective cases. Lymph node yield greater than 15 was achieved in 94.74% of emergency cases and 98.99% of elective cases (p = 0.2973). No conversion occurred in 89.47% of emergency cases versus 97.98% of elective cases (p = 0.1211). Overall compliance was lower in emergency resections (84.21%) than elective resections (94.95%). No statistically significant differences were identified between groups for R0 clearance, lymph node yield, or conversion rates.
Conclusion
Emergency resections for colon cancer can achieve oncological outcomes comparable to elective surgery when measured against established guidelines. Although compliance was lower in emergency cases, differences in key parameters were not statistically significant. Limitations include the retrospective design and small cohort size. Larger studies are needed to confirm these findings.