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Difficult Decisions in Colorectal Cancer in Emergency Settings

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Emergency Surgical Management of Colorectal Cancer

Part of the book series: Hot Topics in Acute Care Surgery and Trauma ((HTACST))

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Abstract

Critically ill patients and pregnant patients with colorectal cancer represent a group where management decisions are difficult.

Critically ill patients with colorectal cancer have been described to be admitted electively after surgery or urgently, with elective admission associated with improved outcomes. Patients with a considerable lifespan should be admitted without limitations as prognosis has been improving, but intensive care admission may be considered for a period (ICU trial) for patients with more stringent criteria. End-of-life discussions should take place as they are an important part of care.

Colorectal cancer diagnosed during pregnancy is generally associated with advanced disease and carries a poor prognosis. There is no consensual management algorithm and decisions made in this context should be multidisciplinary.

Communication between surgeon and patient is a cornerstone of treatment in these complex scenarios. A framework for this discussion is presented in the end of this chapter.

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Author information

Author notes

  1. Gianluca Pellino and António S. Soares contributed equally to this chapter.

Authors and Affiliations

  1. Unit of Colorectal Surgery, University Hospital “La Fe”, Valencia, Spain

    Gianluca Pellino & Matteo Frasson

  2. Department of Advanced Medical and Surgical Sciences, Università della Campania “Luigi Vanvitelli”, Naples, Italy

    Gianluca Pellino

  3. Department of Surgery and Interventional Sciences, University College London Hospitals, NHS Trusts, GENIE Centre, University College London, London, UK

    António S. Soares

Authors
  1. Gianluca Pellino
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  2. António S. Soares
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  3. Matteo Frasson
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Editor information

Editors and Affiliations

  1. Department of General Surgery Unit of Digestive, Minimally Invasive and Robotic Surgery, Henri Mondor Hospital, Créteil, France

    Nicola de'Angelis

  2. Cambridge Colorectal Unit, Cambridge Biomedical Campus, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, UK

    Salomone Di Saverio

  3. Department of General Surgery Unit of Digestive, Minimally Invasive and Robotic Surgery, Henri Mondor Hospital, Créteil, France

    Francesco Brunetti

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Pellino, G., Soares, A.S., Frasson, M. (2019). Difficult Decisions in Colorectal Cancer in Emergency Settings. In: de'Angelis, N., Di Saverio, S., Brunetti, F. (eds) Emergency Surgical Management of Colorectal Cancer. Hot Topics in Acute Care Surgery and Trauma. Springer, Cham. https://doi.org/10.1007/978-3-030-06225-5_24

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  • DOI: https://doi.org/10.1007/978-3-030-06225-5_24

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  • Online ISBN: 978-3-030-06225-5

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