| Title: |
Comparison of Short-term and Long-term Results in the Treatment of Patients with Malignant Colorectal Obstruction: Emergency Resection or Stenting or Transanal Decompression Tube. |
| Authors: |
Vodoleev, Aleksandr; Kriazhev, Denis; Duvanskiy, Vladimir; Pirogov, Sergey; Klimov, Alexey; Perfil'ev, Ilya; Karpova, Elena; Sukhin, Dmitriy; Veselov, Vladimir; Yarotskov, Ivan; Sidorov, Dmitriy; Lozhkin, Mikhail; Grishin, Nikolay |
| Source: |
Gut & Liver; Nov2019, Vol. 13 Issue 6(suppl. 1), p67-67, 1/3p |
| Subject Terms: |
LYMPHADENECTOMY; LARGE intestine; SURGICAL emergencies; POSTOPERATIVE period; BOWEL obstructions; COLON (Anatomy) |
| Abstract: |
Background/Aims Colorectal cancer is complicated by large bowel obstruction in 7% to 29% of patients. Emergency colon resection (especially with lymphadenectomy) is associated with high mortality and complications rates. SEMS or transanal decompression tube placement as a bridge to surgery has been reported to improve short-term outcomes. However, oncological safety of endoscopic interventions is disputable. Despite the large number of guidelines and meta-analysis, there is no consensus in the treatment of this group of patients. The aim of our study was to evaluate the short-term and long-term results of treating patients with malignant colon obstruction using three different strategies (emergency surgery, stenting, and transanal decompression). Methods We analyzed date of 131 patients (55 in surgery group, 42 in SEMS and 34 in TDT group) who were hospitalized in our clinics with malignant colonic obstruction between December 2012 and February 2019. Groups were comparable in terms of baseline characteristics of patients. Results Complications were diagnosed in 20%, 9.8% and 20% patients (p=0,1890, Fisher test). Primary anastomosis rate was significantly higher in the SEMS group: 51.0%, 90.2% and 46.7% (p=0.01, Fisher test). Permanent stoma creation rate was significantly lower is SEMS group 29.1%, 2.7% and 7.1%, respectively. In long-term period rate of recurrence and progression of the disease was 9.1%, 14.6% and 8.8% patients, respectively (p=0.4196, chi-square). Total 1-year survival was 81.0%, 84.7% and 83.3% (p=0.423), 3-year survival was 59.2%, 69.4% and 63.9% (p=0.460), respectively (not statistically significant different). Conclusions SEMS has some benefits in comparison with emergency surgery and transanal decompression tubes in the short-term postoperative period for patients with malignant colorectal obstruction. The overall recurrence rate was higher in the stent group in long-term period, but not statistically significant different. Moreover, the overall survival rate in the group was similar. Need to continue research to material accumulation and analysis of long-term results. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |