[Complicated colorectal cancer--new trends in its diagnosis and surgical treatment]. / Uslozhnen kolo-rektalen rak--novi nasoki v diagnostikata i operativnoto lechenie.

ABSTRACT

Colorectal carcinoma is among the commonest cancer diseases of the alimentary canal in this country. The morbidity and mortality rates show an increase on an annual basis. A total of 1094 patients presenting colorectal carcinoma are analyzed over the period 1985 through 1996. In 690 cases (63.1 per cent) a complicated form of the basic disease is established. For the first time in this country, assessment of the total amount of bile acids in feces using thin-layer chromatography is done, as well as of cholesterol, beta-lipoproteins and triketosteroids in the serum. As shown by the investigations, there is a correlation between increased bile acid concentrations in the feces, decreased values of serum cholesterol, high concentrations of triketosteroids and severe dysbacteriosis, revealing in turn new aspects in the etiopathogenesis, early diagnosis and prophylaxis against colorectal carcinoma. The new principles of surgical management in complicated colorectal carcinoma improve considerably the 5-year survivorship, amounting to 22.1 per cent for T4.