Impactul pandemiei COVID-19 asupra screening-ului cancerului colorectal

Nicolae Anestiadi Department of Surgery no. 1, Nicolae Testemitanu SUMPhBackground. Colorectal cancer (CRC) is the third type of cancer globally diagnosed. Detecting of the early stages would reduce mortality. Since the onset of COVID-19, medical resources have been redirected, resulting in a sharp decline in CRC screening. Objective of the study. Presentation of recent information on the impact of COVID-19 in the early detection of CRC. Material and Methods. Bibliographic sources from the Medline, PubMed, Google Academic databases for the years 2019 – 2021 were used to study the effects of the COVID-19 on the early detection of CRC. The search was perfomed by the following keywords: colorectal cancer, COVID-19, screening. Results. The processing of articles from online databases, in accordance with the search criteria, highlighted 63 works: 18 – dedicated to barriers in detecting of CRC, 11 – on the adaptation of screening methods, 14 – on open access colonoscopy, 12 – related to medical factors and 8 – to factors related to patients who blocked CRC screening. Thus, the negative effect of Covid-19 was determined by reducing the early diagnosis rate of CRC by 85%. The causes being: redistribution of medical and financial resources, limitation of endoscopic investigations, stopping of examinations and scheduled interventions. Conclusion. The COVID-19 has severaly disrupted CRC screening, and its adaptation requires the implementation of individualized screening strategies, more accessible and convenient options for patient compliance.Introducere. Cancerul colorectal (CCR) reprezintă al III -lea tip de neoplazie diagnosticată la nivel global. Depistarea stadiilor incipiente ar duce la reducerea mortalității. De la debutul COVID-19, resursele medicale au fost redirecționate, rezultând o scădere bruscă a screening-ului CCR. Scopul lucrării. Prezentarea informațiilor recente privind impactul COVID-19 în depistarea precoce a CCR. Material și Metode. Au fost utilizate sursele bibliografice din bazele de date Medline, PubMed, Google Academic, din perioada anilor 2019-2021, pentru a studia efectele pandemiei COVID-19 asupra depistării precoce a CCR. Căutarea a fost efectuată după următoarele cuvinte-cheie: cancer colorectal, COVID-19, screening. Rezultate. Prelucrarea articolelor din bazele de date on-line, în concordanță cu criteriile de căutare, au evidențiat 63 de lucrări: 18 – dedicate barierelor în depistarea CCR, 11 – referitoare la adaptarea metodelor de screening, 14 – privind colonoscopia cu acces deschis, 12 – referitoare la factorii medicali și 8 – la factorii legați de pacienți care au blocat screening-ul CCR. Astfel, s-a determinat efectul negativ al COVID-19, prin reducerea ratei de diagnosticare în stadii precoce a CCR cu 85%. Cauzele fiind: redistribuirea resurselor medicale și financiare, limitarea investigațiilor endoscopice, anularea examinărilor și a intervențiilor programate. Concluzii. Pandemia COVID-19 a perturbat major screening-ul CCR, iar adaptarea acestuia necesită implementarea unor strategii individualizate de screening, opțiuni mai accesibile și convenabile pentru complianța pacienților

Importanța pregătirii colonului către colonoscopie în depistarea leziunilor mucoasei

Background. Colorectal cancer (CRC) is one of the most common neoplastic diseases in the world. Colonoscopy is the reference method that allows a complete examination of the intestinal mucosa and early detection of its lesions. Objective of the study. Presentation of information on the importance of colon preparation for colonoscopy for highlighting diseases of the intestinal mucosa. Material and Methods. 90 literary sources from the PubMed database were analyzed over a period of 10 years. Keywords: colorectal cancer, colonoscopy, colorectal lesions, polyethylene glycol. Results. Out of 90 articles: 20 – dedicated to the effectiveness of colon preparation, 14 – the type of preparations used, 46 – the factors that influence the quality of the preparation, 10 – its classification scales. There are different means for colon preparation: polyethylene glycol, magnesium oxide, sodium phosphate, etc. Inadequate colon preparation has a negative impact on the rate of neoplasms, increases the time to perform the procedure and shortens the time required for further supervision and investigations. Metacron CRC was found to be detected in most patients with complete colonoscopies, with lesions missed on initial screening being caused by poor colon preparation. Conclusion. The analysis of the literature highlights the importance of qualitative preparation of the colon for endoscopy, this being essential in the early detection of flat and serial lesions, involved in the development of CRC. Introducere. Cancerul colorectal (CCR) reprezintă una dintre cele mai frecvente maladii neoplazice de pe glob. Colonoscopia este metoda de referinţă care permite examinarea completă a mucoasei intestinale și depistarea precoce a leziunilor acesteia. Scopul lucrării. Prezentarea informațiilor privind importanța pregătirii colonului către colonoscopie pentru evidențierea maladiilor mucoasei intestinale. Material și Metode. Au fost analizate 90 surse literare din baza PubMed pe termen de 10 ani. Cuvinte-cheie: cancer colorectal, colonoscopie, leziuni colorectale, polietilenglicol. Rezultate. Din 90 de articole: 20 – dedicate eficacității și siguranței pregătirii colonului, 14 – tipului preparatelor utilizate, 46 – factorilor care influențează calitatea pregătirii, 10 – scalelor de clasificare a acesteia. Există diferite mijloace pentru pregătirea colonului: polietilenglicol, oxid de magneziu, sodiu fosfat, etc. Pregătirea inadecvată a colonului are impact negativ asupra ratei de depistare a neoplaziilor, crește timpul procedurii și reduce durata necesară pentru supraveghere ulterioară. S-a constatat că CCR metacron a fost depistat la majoritatea pacienților cu colonoscopii complete, leziunile ratate la screening-ul inițial fiind cauzate de pregătirea precară a colonului. Concluzii. Analiza literaturii de specialitate evidențiază importanța pregătirii calitative a colonului către endoscopie, aceasta fiind esențială în detectarea timpurie a leziunilor plate și seriate, implicate în dezvoltarea CCR

Fecal microbial markers–the role in colorectal cancer screening: a review of literature

Department of Surgery no.1 Nicolae Anestiadi; Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, The 8th International Medical Congress for Students and Young Doctors, September 24-26, 2020Introduction. Colorectal cancer (CRC) is the third most common cancer worldwide, accounting for about 10% of all cancer cases diagnosed annually. Due to the high prevalence of CRC, implementation of a screening program, especially non-invasive would reduce the incidence by eradicating precancerous lesions, as well as mortality by treating the early stages of the disease. Aim of the study. Presentation of recent information on the role of fecal microbial markers as a non-invasive method in the early detection of CRC. Materials and methods.. 47 literary sources were analyzed, using Medline, PubMed, Google Scholar, Hindawi databases over a 5 year period. Keywords used in the search: microbial markers, screening, colorectal cancer. Results. Of the 47 articles selected: 16–dedicated to clinical diagnostic methods, 10–regarding the fecal immunochemical test (FIT), 11–regarding the role of fecal microbial markers in combination with FIT, as predictors of CRC and 10–regarding the specificity and sensitivity of the markers fecal microbes in symptomatic and asymptomatic patients. Thus, it was determined that certain bacterial species, such as Parvimonas micra, Solobacterium moorei, and Clostridium hathewayi, are significantly enriched in stool samples from CRC patients, whereas the presence of other bacterial species, such as Bacteroides clarus and Roseburia intestinalis, is significantly reduced in CRC patient stool. Also, Fusobacterium nucleatum is thought to potentiate intestinal tumorigenesis through recruitment of infiltrating immune cells and via activation of beta-catenin signaling. Such increased or decreased presence of these bacterial species results in higher or lower levels of signature DNA, RNA and protein species unique to these species, witch in turn can be used for detection, both qualitatively and quantitatively. Conclusions. This review highlights the effectiveness of non-invasive methods in the early diagnosis of CRC, in estimating the risk of relapse and neoplastic dissemination, as well as the rate of response to adjuvant treatment. Implementing an effective screening program would reduce mortality in CRC, save a significant portion of the resources that would be spent on treating patients in advanced stages of the disease

The importance of colonoscopy bowel preparation for the detection of colorectal lesions

State University of Medicine and Pharmacy „Nicolae Testemițanu”, Department of Surgery nr. 1 „ Nicolae Anestiadi”, Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină și Farmacie „Nicolae Testemițanu” din Republica Moldova, Ziua internațională a științei pentru pace și dezvoltareIntroduction. Colorectal cancer (CRC) is one of the most common neoplastic diseases in the world. Colonoscopy is the reference method that allows a complete examination of the intestinal mucosa and early detection of its lesions [Petrelli F.,2016]. Purpose. Presentation of information on the importance of colon preparation for colonoscopy or highlighting diseases of the intestinal mucosa. Material and methods. 90 literary sources from the PubMed database were analyzed over a period of 10 years. Results. There are different means for colon preparation: polyethylene glycol, magnesium oxide, sodium phosphate, etc. Inadequate colon preparation has a negative impact on the rate of neoplasms, increases the time to perform the procedure and shortens the time required for further supervision and investigations [Zauber A.,2012]. Metacron CRC was found to be detected in most patients with complete colonoscopies, with lesions missed on initial screening being caused by poor colon preparation [Prateek S.,2020]. Conclusions. The analysis of the literature highlights the importance of qualitative preparation of the colon for endoscopy, this being essential in the early detection of flat and serial lesions, involved in the development of CRC

Hartmann procedure in emergency colorectal surgery – a single center experience

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Procedeul Hartmann (PH) este o intervenție frecvent efectuată pentru formațiunile tumorale complicate ale hemicolonului stâng. Rezecția colonului de tip Hartmann este considerată rapidă și sigură, fiind folosită în special, în cazurile de urgență. Scop: Concretizarea indicațiilor PH în intervențiile de urgență pe colonul stâng. Material și metode. Studiu retrospectiv pe 79 pacienți cu cancer colorectal complicat (CCRc) operați în urgență, în cadrul IMU (Chișinău) în perioada 2019-2022. Raportul B:F = 1.1:1, vârsta medie – 70.1±1.34 ani. Indicațiile preoperatorii au fost: ocluzia intestinală acută(OIA) – 62(78.5%) și perforație cu peritonită – 17(21.5%) operate în primele 8 ore de la spitalizare. Localizarea tumorii a fost: sigmoidul – 39(49.4%), descendentul – 16(20.2%), joncțiunea rectosigmoidiană – 24(30.4%) (p<0.01). Rezultate. Majoritatea bolnavilor au fost operați în baza examenului radiologic panoramic al abdomenului și doar 9(11.4%) – prin irigografie de urgență. În toate cazurile s-a aplicat procedeul Hartmann. Au necesitat relaparotomie 5(6.3%) bolnavi pentru necroza stomei. Mortalitatea postoperatorie generală a constituit 29.1% (n = 23), indusă de complicații cardio-pulmonare și infecția COVID-19. Concluzii. PH este o intervenție salvatoare și o bună opțiune pentru pacienții cu formațiuni maligne complicate ale colonului stâng. Indicațiile acestei proceduri se limitează la cazurile de urgență, când aplicarea anastomozei primare este riscantă. PH este încă unul fezabil din punct de vedere tehnic și cu rezultate rezonabile.Background. Hartmann’s procedure (HP) is a commonly performed operation for complicated left colon malignancy. Colonic resection according to the procedure by Hartmann is considered a fast and safe surgical intervention, which has been used for years, in particular, in emergencies. Objective of the study. To define indication of HP under emergency interventions on the left colon. Materials and Methods. Retrospective study of 79 patients with complicated colorectal cancer (CCRC) operated in emergency at Institute of Emergency Medicine (Chișinău), during 20192022. Ratio M:F = 1.1:1, mean age – 70.1±1.34 years. The indications were intestinal obstruction (IO) – 62 (78.5%) and perforation with peritonitis – 17 (21.5%) operated in the first 8 hours. Localization – sigmoid colon – 39 (49.4%), descending colon – 16 (20.2%), rectosigmoid junction – 24 (30.4%) (p<0.01). Results. Most of the patients were operated on the basis of the panoramic radiological examination of the abdomen and only 9 (11.4%) – by emergency irrigography. Were performed in all cases Hartmann procedure. In 5 (6.3%) cases the colostomy was complicated with necrosis. The post-operative mortality rate was 29.1% (n = 23), induced by cardio-respiratory diseases and COVID-19 infection. Conclusion. HP can be a life-saving procedure and suitable option in patients with left sided colonic emergencies. The indications to this procedure are limited to emergency when immediate anastomosis is not possible. Today HP are technically feasible with reasonable outcomes

Manual vs. mechanical anastomosis in colon resections – are there any risk factors?

Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova. The 7th International Medical Congress for Students and Young DoctorsIntroduction. Colonic resections with intestinal anastomosis are laborious interventions that require advanced technical skills. Modern technologies provide new equipment and mechanical devices for anastomosis which come to simplify the surgery. Aim of the study. Analysis of the risk factors in colon resections according to the type of anastomosis. Materials and methods. A retrospective study was made with the analysis of the patient's medical history and the operative protocols of 130 patients with colorectal resections completed with anastomosis in the PMSI IEM during 2015-2017. The postoperative evolution of patients with anastomosis was analyzed according to the time of surgery, type of anastomosis (mechanical / manual), type of continuity, location of anastomosis, duration of surgery, age of patients. Results. The results of the analysis were as follows: ratio M:F - 4:5; average age - 61.45 ± 1.3 years. 84 (64.62%) patients underwent resections with manual anastomosis and 46 (35.38%) - mechanical anastomosis (p <0.001). 74 (56.92%) patients underwent an emergency surgery, 56 (43.07%) had elective interventions, there was no significant difference between these groups. The postoperative period has evolved with anastomotic leakage in 6 (4.62%) cases: 3 (3.57%) with manual anastomosis and 3 (6.52%) with mechanical (p> 0.05). There were 5 (5.95%) leakage cases in the left colon resections - no significant difference compared to their incidence in the right hemicolectomy - 1 (2.22%). There were no significant differences in the location of anastomosis: of the rectum region 3 (7.69%), colo-colic 2 (4.28%), with ileum 1 (2%). According to the continuity of the anastomosis, two cases of leakage were observed: 6.67% in the termino-lateral anastomosis, 5.56% in the lateral-lateral and 3.13% in the termino-terminal, (p> 0.05). Age did not manifest itself as a risk factor for anastomotic fistula, 69.33 ± 4.4 years in patients with anastomotic leakage compared to 60.48 ± 1.36 in survivors (p> 0.05). Although the duration of the surgery with mechanical anastomosis was less (154.9 ± 9.14min) compared to manual anastomosis (173.47 ± 8.49min), no significant differences were observed, similar to the duration of the operation with favorable evolution compared to the cases of anastomosis dehiscence, respectively 168.53 ± 1.36min versus 140.33 ± 8.8min. 12 (9.2%) patients died. Conclusions. Although the rate of manual anastomosis significantly outweighs the mechanical ones in colon resections (p<0.001), there were no risk factors with significant difference regarding the incidence of anastomotic leakage according to the parameters analyzed

SYNCHRONUS COLORECTAL CANCERS – DIAGNOSIS AND TREATMENT

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Tumorile colorectale sincrone (TCS) se referă la mai mult de o tumoră primară detectată la un singur pacient la prezentarea inițială. TCS are o incidență de 1.8-12.4% și poate avea mai multe localizări simultane pe traiectul colonului. Scopul lucrării. Analiza particularităților de diagnostic și tratament al tumorilor sincrone colorectale. Material și Metode. Studiu retro- și prospectiv pe 475 de pacienți cu cancer colorectal (CCR), spitalizați și operați în cadrul IMU (Chișinău), în 2017-2021. Dintre aceștia 8 (1.68%) pacienți au prezentat tumori colorectale multiple. Raportul B:F = 1.19:1, vârsta medie – 65.41±1.32 ani (p < 0.01). Rezultate. Majoritatea pacienților cu TCS – 6 (1.26%) s-au prezentat în urgență cu sindrom subocluziv sau ocluzie intestinală acută (OIA) prin tumoră colorectală stenozantă. Localizările tumorii stenozante au fost sigmoidul – 6 (1.26%) cazuri, cu sediul celei sincrone pe transvers – 5 (1.05%) și 1 (0.21%) – pe ascendent, depistate intraoperator. Celelalte 2(0.42%) cazuri localizate pe ascendent, tumorile sincrone fiind depistate pe descendent (n = 1) și sigmoid (n=1), depistate intraoperator. În 4 (0.84%) cazuri, cauza OIA a fost depistată prin irigografie, ceilalți bolnavi au fost operați în baza examenului radiologic. S-au efectuat operații radicale (n = 6) cu anastomoză primară și în 2 cazuri – colostomii. Evoluția postoperatorie a fost favorabilă și în corelație cu complicațiile bolii de bază. Concluzii. Depistarea preoperatorie a tumorilor sincrone este dificilă, fiind determinată de circumstanțele urgenței (OIA, colon nepregătit, imposibilitatea examinării colonoscopice). Este necesară vigilența chirurgului și examinarea minuțioasă intraoperatorie a colonului pentru a exclude leziunile sincrone și a evita reintervenția chirurgicală.Background. Synchronous colorectal cancers (SCC) refer to more than one primary tumor detected in a single patient at the initial presentation. SCC has an incidence of 1.8-12.4% and can have several simultaneous locations in colon. Objective of the study. Analysis of the particularities of diagnosis and treatment of SCC. Material and Methods. Retroand prospective study on 475 patients with colorectal cancer (CRC) hospitalized and operated in Institute of Emergency Medicine during 2017-2021. Of these, eight (1.68%) patients had multiple colorectal tumors. Ratio M:F = 1.19:1, mean age – 65.41±1.32 years (p < 0.01). Results. The majority of patients with SCC – 6 (1.26%) presented in emergency with subocclusive syndrome or acute intestinal obstruction (AIO) due to stenotic colorectal tumor. The locations of the stenotic tumor were the sigmoid – 6 (1.26%) cases, with the location of the synchronous one on the transverse – 5 (1.05%) and 1 (0.21%) – on the ascending, detected intraoperatively. The other two (0.42%) cases were located in the ascending, the synchronous tumors being located in the descending (n = 1), another on the sigmoid, detected intraoperatively. In 4 (0.84%) cases, the cause of AIO was detected by irigography, the other patients were operated in base on a simple radiological examination. Radical operations were performed in 6 cases with primary anastomosis and in 2 cases – colostomies. The postoperative evolution was satisfactory and correlated with the complications of the underlying disease. Conclusion. Preoperative detection of SCC is difficult, being determined by the emergency presentation of patients with AIO and insufficiently prepared for colonoscopy examination. Surgeon’s vigilance and thorough examination of the colon during surgery is necessary to detect synchronous lesions and avoid reoperation

Tumori sincrone colorectale – particularități diagnostico-curative

Background. Synchronous colorectal cancers (SCC) refer to more than one primary tumor detected in a single patient at the initial presentation. SCC has an incidence of 1.8-12.4% and can have several simultaneous locations in colon. Objective of the study. Analysis of the particularities of diagnosis and treatment of SCC. Material and Methods. Retroand prospective study on 475 patients with colorectal cancer (CRC) hospitalized and operated in Institute of Emergency Medicine during 2017-2021. Of these, eight (1.68%) patients had multiple colorectal tumors. Ratio M:F = 1.19:1, mean age – 65.41±1.32 years (p < 0.01). Results. The majority of patients with SCC – 6 (1.26%) presented in emergency with subocclusive syndrome or acute intestinal obstruction (AIO) due to stenotic colorectal tumor. The locations of the stenotic tumor were the sigmoid – 6 (1.26%) cases, with the location of the synchronous one on the transverse – 5 (1.05%) and 1 (0.21%) – on the ascending, detected intraoperatively. The other two (0.42%) cases were located in the ascending, the synchronous tumors being located in the descending (n = 1), another on the sigmoid, detected intraoperatively. In 4 (0.84%) cases, the cause of AIO was detected by irigography, the other patients were operated in base on a simple radiological examination. Radical operations were performed in 6 cases with primary anastomosis and in 2 cases – colostomies. The postoperative evolution was satisfactory and correlated with the complications of the underlying disease. Conclusion. Preoperative detection of SCC is difficult, being determined by the emergency presentation of patients with AIO and insufficiently prepared for colonoscopy examination. Surgeon’s vigilance and thorough examination of the colon during surgery is necessary to detect synchronous lesions and avoid reoperation.Introducere. Tumorile colorectale sincrone (TCS) se referă la mai mult de o tumoră primară detectată la un singur pacient la prezentarea inițială. TCS are o incidență de 1.8-12.4% și poate avea mai multe localizări simultane pe traiectul colonului. Scopul lucrării. Analiza particularităților de diagnostic și tratament al tumorilor sincrone colorectale. Material și Metode. Studiu retro- și prospectiv pe 475 de pacienți cu cancer colorectal (CCR), spitalizați și operați în cadrul IMU (Chișinău), în 2017-2021. Dintre aceștia 8 (1.68%) pacienți au prezentat tumori colorectale multiple. Raportul B:F = 1.19:1, vârsta medie – 65.41±1.32 ani (p < 0.01). Rezultate. Majoritatea pacienților cu TCS – 6 (1.26%) s-au prezentat în urgență cu sindrom subocluziv sau ocluzie intestinală acută (OIA) prin tumoră colorectală stenozantă. Localizările tumorii stenozante au fost sigmoidul – 6 (1.26%) cazuri, cu sediul celei sincrone pe transvers – 5 (1.05%) și 1 (0.21%) – pe ascendent, depistate intraoperator. Celelalte 2(0.42%) cazuri localizate pe ascendent, tumorile sincrone fiind depistate pe descendent (n = 1) și sigmoid (n=1), depistate intraoperator. În 4 (0.84%) cazuri, cauza OIA a fost depistată prin irigografie, ceilalți bolnavi au fost operați în baza examenului radiologic. S-au efectuat operații radicale (n = 6) cu anastomoză primară și în 2 cazuri – colostomii. Evoluția postoperatorie a fost favorabilă și în corelație cu complicațiile bolii de bază. Concluzii. Depistarea preoperatorie a tumorilor sincrone este dificilă, fiind determinată de circumstanțele urgenței (OIA, colon nepregătit, imposibilitatea examinării colonoscopice). Este necesară vigilența chirurgului și examinarea minuțioasă intraoperatorie a colonului pentru a exclude leziunile sincrone și a evita reintervenția chirurgicală

Chirurgia de urgență a cancerului colorectal ocluziv

Nicolae Anestiadi Department of Surgery no. 1, Nicolae Testemitanu SUMPhBackground. Emergency interventions in occlusive colorectal cancer (OCRC) are associated with high rates of morbidity and mortality, determined by the therapeutic attitude and comorbidities of patients, the ways to complete the intervention being the primary anastomosis or the external derivation. Objective of the study. Analysis of the result of surgical treatment of OCRC in emergencies. Material and Methods. Retrospective study on 90 patients with OCRC, operated in Emergency Hospital (Chișinău), between 2018 and 2020. Ratio M:W=1.1:1, average age – 63.96±1.34 years. With location on the right side – 30(33.3%), transvers colon – 8(8.8%), left side – 52(57.7%). Results. Cause of hospitalization: acute intestinal occlusion (AIO) and peritonitis – 22(22.44%), AIO – 25(27.7%), subocclusion – 43(47.7%). Performed hemicolectomies: right – 24(26.67%), including 7(7.78%) extended, left – 42(46.67%), Hartmann operations – 17(18.9%). In the right OCRC 25(80.65%) ileotransversostomies and 6(19.35%) ileostomies were performed. In the left OCRC were applied 34(80.95%) internal derivations, 3(7.14%) transversostomies and 5(11.9%) STEC. Leakages were recorded in 5.1% (n=3), resolved by relaparotomy and external derivation. General mortality was 21.1% (n=19), of which 8(42.1%) with primary anastomoses and 11(57.9%) with external derivations. Conclusion. The type of surgery is determined by the location of the tumor and the degree of intestinal occlusion. The specific complications did not influence the lethality, which was strictly dependent on homeostasis disorder caused by late occlusion.Introducere. Intervențiile de urgență în cancerul colorectal ocluziv (CCRO) sunt asociate cu rate mari de morbiditate și mortalitate, determinate de atitudinea terapeutică și comorbiditățile pacienților, modalitățile de finalizare a intervenției fiind anastomoza primară sau derivația externă. Scopul lucrării. Analiza rezultatelor tratamentului chirurgical al CCRO în urgențe. Material și Metode. Studiu retrospectiv pe 90 de pacienți cu CCRO, operați în IMU, în perioada 2018-2020. Raportul B:F=1.1:1, vîrsta medie–63.96 ani. Cu localizare pe dreapta–30(33.3%), transvers–8(8.8%), stânga–52(57.7%). Rezultate. Cauza spitalizării: ocluzie intestinală acută (OIA) și peritonită–22(22.44%), OIA– 25(27.7%), subocluzie–43(47.7%). Hemicolectomii efectuate: drepte – 24(26.67%), inclusiv 7(7.78%) extinse pe dreapta, stânga–42(46.67%), rezecții de sigmă–17(18.9%). În CCRO drept s-au efectuat 25(80.65%) ileotransversostomii și 6 (19.35%) ileostomii. În CCRO stâng: 34(80.95%) anastomoze primare, 3(7.14%) transversostomii, 5(11.9%) STEC și 17(18.9%) operații Hartmann. Dehiscențe s-au înregistrat în 5.1%(n=3), rezolvate prin relaparotomie și derivație intestinală externă. Mortalitatea generală a constituit 21.1%(n=19), dintre care 8(42.1%) cu anastomoze primare și 11(57.9%) cu derivații externe. Concluzii. Tipul intervenției chirurgicale este determinat de sediul tumorii și gradul ocluziei intestinale. Complicațiile specifice nu au influențat letalitatea, aceasta fiind strict dependentă de dereglarea homeostaziei determinată de ocluzia tardivă