Complete single-stage management of left colon cancer obstruction with a new device

Shon, Dae-Ho; Kang, Su Hwan; Jang, Byung Ik; Chung, Moon Kwan; Kim, J.-H.; Shim, Min Chul

doi:10.1007/s00464-004-8232-3

Cited by 13 publications

(11 citation statements)

References 29 publications

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“…Because these are elderly patients with poor performance status, who presented with a lot of comorbidities, the question is -is the removal of the primary tumor accompanied by a prolongation of the patient's life (2,(4)(5)(6)(7)(8)(9)? Obstructive complications were observed in 10-29% of patients with advanced colorectal cancer at the time of the diagnosis (10). Pazzini and coll.…”

Section: Discussionmentioning

confidence: 99%

The place of palliative multivisceral resections for locally advanced colorectal cancer

Marinov

2016

SSM

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BACKGROUND:The performance of multivisceral resections in cases of locally and systematically advanced colorectal cancer has its own place in the treatment of this disease. This approach is usually used in young patients as a part of two-stage surgical strategy or combined with adjuvant chemotherapy to achieve the re-staging of systemic metastases. Avoiding colostomy and better quality of life is a strong motive to move in this direction. AIM:To determine the indications and early postoperative results in a group of patients with locally and systemically advanced colorectal cancer with multivisceral resection of a local disease. MATERIALS AND METHODS: For a period of 8 years 2007 -2014, 27 patients with distant metastases underwent local multivisceral resection.For the same period a total of 191 patients were operated for locally advanced CRC. All methods for early postoperative results assessment were used. RESULTS:The average age in the group was 64 years. The perioperative mortality rate was 3.7% and the morbidity was 14.8%. We performed colostomy in only 3 cases. CONCLUSION:Aggressive surgical attempt is justified in selected patients and it is connected with low mortality and morbidity rate. The quality of life is a strong reason for such therapeutic strategy.

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Section: Discussionmentioning

confidence: 99%

The place of palliative multivisceral resections for locally advanced colorectal cancer

Marinov

2016

SSM

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“…Despite the increased public attention to screening and the awareness of the importance of early diagnosis, several patients present with advanced colorectal cancer and unresectable metastases at the time of diagnosis (1, 2); 10 to 20% have also symptoms of subacute large bowel obstruction and 8 to 29% of complete obstruction (22). Surgery conducted for these patients has a 15 to 20% death rate and a 50% complication rate (23).…”

Section: Discussionmentioning

confidence: 99%

Quality of Life for Patients With Incurable Stage IV Colorectal Cancer: Randomized Controlled Trial Comparing Resection Versus Endoscopic Stenting

Fiori

Lamazza

Sterpetti

et al. 2019

In Vivo

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Background/Aim: A prospective randomized open label parallel trial, comparing the quality of life (QoL) after endoscopic placement of a self-expandable metal stent or primary tumor resection, in patients with stage IV colorectal cancer was performed. Patients and Methods: Thirty-three patients affected with stage IV colorectal cancer and unresectable metastases were randomly assigned into two groups: Group 1 (16 patients), that underwent selfexpandable metal stent positioning and Group 2 (17 patients), in which primary tumor resection was performed. Karnofsky performance scale and QoL assessment using the EQ-5D-5L™ questionnaire was administered before treatment and thereafter at 1, 3 and 6 months. Results: At 1 month, index values showed a statistically significant deterioration of the QoL in patients of Group 2 when compared to those of Group 1 (p=0.001; 95%CI=0.065-0.211) whereas, at 6 months, index values showed a statistically significant deterioration of the QoL in patients of Group 1 (p<0.025; 95%CI=0.017-0.238). Conclusion: QoL in patients affected with stage IV colorectal cancer has a bimodal fluctuation pattern: at 1month it was better in patients that received stent, but at 6months it was significantly better in patients submitted to surgical resection.

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“…After laparotomy, intraoperative colonic lavage was performed through the anus using the New Intraoperative Colonic Irrigator (NICI®, MITech Co., Seoul, Korea) [9] in order to achieve easy manipulation of the colon. For irrigation, approximately 2,000 cm 3 of warm tepid water was used; the washout procedure took 5 min.…”

Section: Methodsmentioning

confidence: 99%

Long-term fecal diverting device for the prevention of sepsis in case of colorectal anastomotic leakage: an animal experiment

Kim

Jung

Park

et al. 2012

Int J Colorectal Dis

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BackgroundA new fecal diverting device (FDD) was fabricated for fecal diversion from the proximal colon above the anastomosis to outside the anus for protecting the rectal anastomosis. The aim of the study is to evaluate the safety and effectiveness of the FDD.MethodsAfter a pilot study, a prospective observational trial was performed in 34 mongrel dogs. The experiment comprised of segmental resection and anastomosis of the colon, fixation of the FDD, and observation for 3 weeks (n = 15) and more than 3 weeks (n = 19) without initiation of parenteral nutrition.ResultsFour cases of perioperative death unrelated to the FDD were excluded. Twenty-six (87 %) of the 30 dogs survived. Sixteen (53 %) dogs were able to retain the FDD for more than 3 weeks until 82 days. The autopsy findings revealed that four (15 %) dogs showed colonic wall erosions and mucosal scarring respectively at the band fixation area without evidence of serious septic complications. The surviving dogs retained the FDD for more than 6 days. Mortality occurred in four of the five dogs that expelled the FDD within three postoperative days. A closed abscess cavity as the evidence of anastomotic leakage was noted in seven (23 %) of the surviving dogs.ConclusionsThe newly designed fecal diverting device can be retained for more than 3 weeks until 82 days without any serious complications. The FDD may prevent sepsis in case of anastomotic leakage if it is retained for more than 6 days.

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Complete single-stage management of left colon cancer obstruction with a new device

Abstract: The new device enabled safe, simple, and time-saving, single-stage surgical management of left colon cancer obstruction. The ability to perform on-table colonoscopy enabled treatment and recognition of synchronous bowel pathology.

Cited by 13 publications

References 29 publications

The place of palliative multivisceral resections for locally advanced colorectal cancer

The place of palliative multivisceral resections for locally advanced colorectal cancer

Quality of Life for Patients With Incurable Stage IV Colorectal Cancer: Randomized Controlled Trial Comparing Resection Versus Endoscopic Stenting

Long-term fecal diverting device for the prevention of sepsis in case of colorectal anastomotic leakage: an animal experiment

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