Primary vs . Delayed Resection for Obstructive Left-Sided Colorectal Cancer: Impact of Surgery on Patient Outcome

Jiang, Jeng‐Kai; Lan, Yuan–Tzu; Lin, Tianyu; Chen, W. S.; Yang, Shung‐Haur; Wang, H. S.; Chang, Shih Ching; Lin, J. K.

doi:10.1007/s10350-007-9173-4

Cited by 55 publications

(40 citation statements)

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“…Furthermore, a bridging strategy results in a higher chance of bowel continuity. Both SEMS and decompressing stoma may be a valid bridging intervention to elective resection [5,18]. The risk of stent-related perforation and its oncological consequences should be balanced against the risk of postoperative mortality, morbidity and risk of permanent stoma in the elderly frail patients.…”

Section: Discussionmentioning

confidence: 99%

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Resection of Obstructive Left-Sided Colon Cancer at a National Level: A Prospective Analysis of Short-Term Outcomes in 1,816 Patients

Tanis¹,

Pereira²,

Hooft

et al. 2015

Dig Surg

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Background/Aims: The prematurely closed Stent-In II trial in patients with left-sided obstructive colon cancer may have influenced clinical decision making in The Netherlands. The aim of this study was to evaluate treatment of left-sided malignant colon obstruction at a population level since then. Methods: Short-term outcomes of all patients who underwent resection for left-sided obstructive colon cancer between 2009 and 2012 were assessed based on a prospective national registry. Results: In total, 1,816 evaluable patients were included; acute resection was performed in 1,485 (81.8%), and endoscopic stent or decompressing stoma followed by resection in 196 (10.8%) and 135 (7.4%), respectively. The use of endoscopic stenting significantly decreased from 18% (2009) to 6% (2012). Overall 30-day or in-hospital mortality rate was 6.9, 5.6, and 3.7%, respectively (p = 0.107). Mortality rate after acute resection was 2.9% in patients >70 years, but mortality rates up to 32.2% were observed in high-risk elderly patients. Conclusion: Acute resection as first choice treatment seems justified for patients >70 years of age given a mortality rate of 3%. For the elderly frail patients, mortality rates over 30% after acute resection stress the need for alternative treatment strategies.

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Section: Discussionmentioning

confidence: 99%

“…The self-expandable metallic stent (SEMS) has been shown to be a successful method for colonic decompression [4]. A valid alternative to SEMS is a decompressing colostomy, which can be constructed via a small transverse incision at the level of the transverse colon [5]. …”

Section: Introductionmentioning

confidence: 99%

Resection of Obstructive Left-Sided Colon Cancer at a National Level: A Prospective Analysis of Short-Term Outcomes in 1,816 Patients

Tanis¹,

Pereira²,

Hooft

et al. 2015

Dig Surg

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show abstract

“…Хотя выбор оптимальной хирургической тактики в отношении больных с левосторонним обструктив-ным КРР остается спорным вопросом [30][31][32][33], ряд проведенных исследований показал лучшие результа-ты при поэтапном хирургическом лечении [14,29,[34][35][36] (табл. 1).…”

Section: Introductionunclassified

“…7 Colorectal КОЛОПРОКТОЛОГИЯ 1' 2017 О б з о р л и т е р а т у р ы использовать 10-и 14-дневные интервалы между 1-м и 2-м этапами хирургического лечения [37]. По дан-ным других авторов, этот временной отрезок варьиру-ет от 11 до 42 дней [35,38,39]. H. Y. Yang и соавт.…”

Section: Introductionunclassified

Surgical treatment of complicated colorectal cancer: tactical aspects (a literature review)

Щаева¹

2017

Onkol. koloproktol.

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“…is among the most diagnosed and lethal malignancies in both men and women, and consists 85% of all these colonic obstructions [1]. In patients with acute mechanical obstruction due to CRC, emergency surgery is associated with significantly increased postoperative morbidity and mortality when compared with the elective ones [2][3][4][5].…”

mentioning

confidence: 99%

Factors Affecting Postoperative Morbidity and Mortality in Obstructing Colorectal Cancer

Kılıç¹

2016

Ann Clin Anal Med

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ÖzetAmaç: Amacımız kolorektal kansere bağlı akut barsak tıkanıklığı nedeniyle acil ameliyat edilen hastalarda postoperatif morbidite ve mortaliteye etki eden faktörleri araştırmaktır. Gereç ve Yöntem: Perforasyonsuz tıkayıcı kolorektal kanser nedeniyle ameliyat edilen 43 hasta retrospektif olarak değerlendirildi. Postoperatif morbidite ve mortaliteyi etkileyen ana prognostik faktörleri belirlemek için lojistik regresyon analizi kullanıldı. Bulgular: Postoperatif dönemde 8 (%18.6) hastada mortalite görülür iken, 16 (%37.6) hastada postoperatif morbidite gelişti. Tek değişkenli analizde, 65 üzeri yaşın (p=0.034), eşlik eden sistemik hastalığın (p=0.035), ileri tümör evresinin (p=0.040) ve yüksek ASA skorunun (p=0.000) postoperatif morbidite gelişimi ile ilişkili olduğu bulundu. Öte yandan, 65 üzeri yaş (p=0.023), eşlik eden sistemik hastalık (p=0.014), yüksek ASA skoru (p=0.010) ve uzak metastaz varlığı (p=0.012) postoperatif mortalite ile ilgili risk faktörleri olarak tanımlan-dı. Lojistik regresyon analizi sonrası, yüksek ASA skoru (p=0.005) ve uzak metastaz varlığı (p=0.000), postoperatif mortalitenin bağımsız prognostik faktörleri olarak saptanırken, 65 yaş üzeri yaş (p=0.023) ve yüksek ASA skoru (p=0.000) postoperatif morbiditenin prognostik faktörler olarak belirlendi. Tartışma: İleri yaş ve eşlik eden sistemik hastalık varlığı tıkayıcı kolorektal kanser için acil ameliyat edilen hastalarda postoperatif morbidite ve mortaliteyi artırır. ASA skoru, hem morbidite hem de mortalite için güçlü bir prognostik faktör olarak, preoperatif risk sınıflandırması ve cerrahi planlamada kolaylıkla kullanılabilir. Anahtar KelimelerKolorektal Kanser; Barsak Tıkanıklığı; Morbidite; Mortalite Abstract Aim: Our aim is to investigate the factors affecting on postoperative morbidity and mortality in patients who underwent emergency surgery for acute intestinal obstruction due to colorectal cancer. Material and Method: Fortythree patients who was operated because of acute obstructing colorectal cancer without perforation were retrospectively evaluated. Logistic regression analysis was used to identify the main prognostic factors affecting postoperative morbidity and mortality. Results: Postoperative morbidity was developed in 16 (37.6%) patients while mortality was seen in 8 (18.6%) patients during the postoperative period. In univariate analysis, age above 65 years (p=0.034), accompanying systemic disease (p=0.035), advanced tumor stage (p=0.040), and high ASA score (p=0.000) were found to be associated with the development of postoperative morbidity. On the other hand, age above 65 years (p=0.023), accompanying systemic disease (p=0.014), high ASA score (p=0.010), and presence of distant metastasis (p=0.012) were identified as the risk factors related to postoperative mortality. After logistic regression analysis, age above 65 years (p=0.023) and high ASA score (p=0.000) were determined as the prognostic factors of postoperative morbidity, while high ASA score (p=0.005) and presence of distant metastasis (p=0.000) were found to ...

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Primary vs . Delayed Resection for Obstructive Left-Sided Colorectal Cancer: Impact of Surgery on Patient Outcome

Abstract: Delayed resection seems to be a safer procedure and provided a better oncologic outcome compared with primary resection in obstructive left-sided colorectal cancer under emergency situations.

Cited by 55 publications

References 20 publications

Resection of Obstructive Left-Sided Colon Cancer at a National Level: A Prospective Analysis of Short-Term Outcomes in 1,816 Patients

Resection of Obstructive Left-Sided Colon Cancer at a National Level: A Prospective Analysis of Short-Term Outcomes in 1,816 Patients

Surgical treatment of complicated colorectal cancer: tactical aspects (a literature review)

Factors Affecting Postoperative Morbidity and Mortality in Obstructing Colorectal Cancer

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