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Acute obstruction appears to be the complication of cancer most likely to end fatally. This survey of surgical practices in central New York state communities of varying size revealed a 22% operative mortality among patients admitted with this complication, contrasted with a 3.7% mortality among all other patients who underwent planned operation. In well over 60% of the former, clear-cut symptoms of obstruction had been present for more than three months. Anemia occurred less commonly in the entire series of 623 patients than is usually reported. This and the presence of an abdominal mass do not unfavorably affect prognosis except in lesions of the transverse colon, sigmoid flexure, or rectum. Anterior resection should be the operation of choice for most lesions in the upper part of the rectum or lower part of the sigmoid flexure.
Gregg RO, Chamberlain BE, Vercillo AA. CARCINOMA OF COLON AND RECTUM: SURVEY OF SURGICAL MANAGEMENT IN CENTRAL NEW YORK STATE. JAMA. 1959;170(2):143–148. doi:10.1001/jama.1959.03010020001001
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