Dr. Patricia Tejedor, colorectal surgeon at Quenet-Torrent Institute, is first author of the article "Clinical spotlight review: best practices for the management of colorectal cancer in the emergency and acute care setting", published in the scientific journal Surgical Endoscopy.
An international scientific collaboration
The work is part of an initiative by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), developed through its Colorectal Surgery and Acute Care Surgery committees.
An international group of expert surgeons participated in the project with a shared goal: to establish practical recommendations for the management of colorectal cancer when it presents as an emergency, particularly in cases of bowel obstruction, perforation, or bleeding.
Why emergency colorectal cancer is a clinical challenge
These emergency presentations represent a significant clinical challenge. They are typically associated with:
- More advanced tumor stage at the time of diagnosis.
- Greater surgical complexity and the need for emergency surgery.
- Increased risk of postoperative complications.
- Worse oncological outcomes in the medium and long term compared with elective surgery.
For this reason, the article reviews the available scientific evidence and proposes action strategies aimed at improving decision-making in highly complex scenarios.
Main recommendations for surgical management
Among its most relevant conclusions, the work highlights the importance of:
- Performing a rapid and accurate diagnosis, optimising initial assessment with contrast-enhanced CT and, where feasible, urgent endoscopy.
- Maintaining the principles of oncological surgery even in the emergency setting: adequate lymphadenectomy, oncological margins, total mesorectal excision when appropriate.
- Tailoring treatment according to tumor location (colon cancer versus rectal cancer) and the clinical status of each patient.
- Considering bridge-to-surgery strategies whenever possible: self-expanding colonic stents in left-sided obstruction, defunctioning stomas, or staged resections, to avoid emergency surgery when the patient's clinical condition allows it.
What this means in clinical practice
The SAGES recommendations give surgeons an evidence-based roadmap for a situation that has traditionally been managed on a case-by-case basis, with heterogeneous criteria across hospitals. Harmonising international criteria is key so that any patient with colorectal cancer presenting as an emergency receives the best possible care, regardless of where they are operated on.
Commitment to research and colorectal surgery
At Quenet-Torrent Institute we share this publication, which reinforces our commitment to research, international scientific collaboration and continuous improvement in the surgical treatment of colorectal cancer.
Dr. Patricia Tejedor leads the colorectal surgery unit at our institute, where we apply the most up-to-date principles and techniques for the integral treatment of colorectal cancer, both in elective and emergency settings.
Further reading
- Colon cancer: what it is, symptoms, diagnosis and treatment
- How to prevent colon cancer: screening and risk factors
- How much do we really know about colon cancer?
Read the full article
You can access the full article on the journal's website: Surgical Endoscopy — SAGES Clinical Spotlight Review.