Pattern of colo-rectal surgery at Dammam Central Hospital

الملخص EN

Objective: This study aims to analyse the patterns of presentation, investigation and surgical management of major colo-rectal diseases admitted to the Department of Surgery, Dammam Central Hospital, one of the major hospitals in the Eastern Province of Saudi Arabia.

Methods: The case notes of all patients who underwent major colo-rectal procedure (excluding piles and ano-rectal sepsis) over 2-year period (1995 and 1996) were retrospectively reviewed.

Results: There were 23 colo-rectal procedures carried out in 21 patients (15 males, 6 females) with mean age of 45 (range 15-75) years during the two year period (1995-1996).

Fifteen patients (70.4%) were Saudis.

The commonest presenting symptoms were: constipation (81%), bleeding per rectum (57%), abdominal pain and discomfort (47.6%), weight loss (42.8%), abdominal mass (19%) and tenesmus (19%).

Ultrasonography was performed in 20 and was informative in 5 cases (mass 3, liver metastases 1 and mesenteric lymphadenopathy in 1).

CT scan was performed in 8 patients and was abnormal in 4.

Nineteen patients (90.5%) underwent colonoscopy, which revealed colonic lesions in fifteen patients.

Only 3 patients had barium enema that showed malignant lesion in 2.

The operations performed were hemicolectomy (eight), anterior resections (four), abdomino-perineal resection of rectum (three), Hartmann’s procedures (two), reversal of Hartmann’s (two), subtotal and total colectomies (three).

Majority of the procedures was carried out for cancer (66.7%), followed by adenoma (9.5%).

There were 4 complications (17%) and 5 deaths (21.7%); all in patients with cancer.

The mean hospital stay was 20 (range 10-67) days.

Conclusion: We conclude that colonoscopy is efficiently used at Dammam Central Hospital to investigate large bowel symptoms replacing barium enema.

Major colo-rectal procedures are conducted at a rate of 1 per month.

Majority (66.5%) of colonic operations performed were for cancer and that surgery for inflammatory bowel conditions seem to be uncommon.