eP542 - Mapping Progress: Multicenter Insights into Colorectal Cancer Colectomy Outcomes in the Dominican Republic

Purpose/Background: Colorectal cancer is recognized as the third most common cancer worldwide. Little is known about its burden and impact on the Dominican Republic. It is imperative to characterize the patient population undergoing surgery for colon cancer to identify potential points of improvement. Following this, the study was conducted on two major hospital settings, HOMS in Santiago and Hospital General de la Plaza de la Salud in Santo Domingo, to better understand the current state of surgical colorectal cancer disease.Methods/Interventions: A retrospective review of medical records of patients undergoing colectomy for colon cancer at two institutions (HOMS and Hospital General de la Plaza de la Salud) was done. The time frame was 6 years. Baseline variables age and gender were recorded. Variables of interest included: if the case was elective or emergent, open vs close surgery, TNM staging, pathologic diagnosis, and location of the lesion. Perioperative variables: intra-op complications, post-op variables: postoperative complications. The main outcome of interest was mortality at 30 days.Results/Outcomes: A total of 261 patients underwent colectomy for colorectal cancer in 6 years at both centers. The mean age of the patients was 63.33 (SD 13.34) Youngest patient was 22 years of age and had a genetic component. 50.2% of the patients were male. ASA class of the patients was 42.5% for class 2 and 46.4 for class 3. Surgery was done emergently in 10.7% of the cases. 8% of the cases were done laparoscopic. 25.3% of the patients required colostomy. Colon cancer stage 3 was the most common with 36.4% of the cases. Most of the patients had T3 tumor stage (26.8%) followed by T4 (14.6%), N1 was present in 38.7% of the patients, and 14.6% had metastatic disease. The most common pathologic finding was well-differentiated adenocarcinoma with 47.1% of the cases. The most common location was ascending colon with 37.5% of the cases followed by sigmoid coon with 34.1%. Complications: intraoperative: 15.3% had complications, 10.3% bowel injury, 1.1% urethral injury, and 13.4% bleeding. Post-op complications were seen in 12.6% of the patients, this included: 2.3% anastomotic leakage, 7.3% surgical site infection, and 3.8% wound dehiscence. 3.8% of the patients required to return to the Operating room. 11.5% of the patients had medical complications: pneumonia (3.1%), cardiac (4.2%), pulmonary embolism (1.1%), Deep vein thrombosis (2.7%), sepsis (1.5%), ileus (0.4%). 30-day mortality was 2.7%.Conclusion/

Discussion: Most of the population that underwent surgery for colon cancer had locally advanced or advanced disease (stage 3) and a substantial number of patients had nodal involvement (N1). This implies potentially a suboptimal of proper screening practices. Surgical interventions were primarily elective, although a notable portion of cases were emergent, emphasizing the significance of early diagnosis and intervention. Laparoscopic surgery was relatively infrequent, indicating an area for potential advancement in minimally invasive techniques in colorectal cancer surgery in the Dominican Republic. The distribution of tumor location within the colon indicated that the ascending colon and sigmoid colon were the most affected sites, reflecting known patterns. Intraoperatively, complications were observed in 15.3% of cases, with bowel injury and bleeding being the most common. Postoperative complications, such as anastomotic leakage and surgical site infections, affected 12.6% of patients. Notably, 30-day mortality was recorded at 2.7%.