Reviewing the Management of Obstructive Left Colon Cancer: Assessing the Feasibility of the One-stage Resection and Anastomosis After Intraoperative Colonic Irrigation.
| Title: | Reviewing the Management of Obstructive Left Colon Cancer: Assessing the Feasibility of the One-stage Resection and Anastomosis After Intraoperative Colonic Irrigation. |
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| Authors: | Awotar GK; Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.; Guan G; Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.; Sun W; Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.; Yu H; Department of General Surgery, The Third Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.; Zhu M; Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.; Cui X; Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.; Liu J; Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.; Chen J; Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.; Yang B; Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.; Lin J; Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.; Deng Z; Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.; Luo J; Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.; Wang C; Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.; Nur OA; Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.; Dhiman P; Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.; Liu P; Institute of Cancer Stem Cell & College of Pharmacy, Dalian Medical University, Dalian, China.; Luo F; Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China. Electronic address: fuwenluo@aliyun.com. |
| Source: | Clinical colorectal cancer [Clin Colorectal Cancer] 2017 Jun; Vol. 16 (2), pp. e89-e103. Date of Electronic Publication: 2017 Jan 18. |
| Publication Type: | Comparative Study; Journal Article |
| Language: | English |
| Journal Info: | Publisher: Elsevier Country of Publication: United States NLM ID: 101120693 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1938-0674 (Electronic) Linking ISSN: 15330028 NLM ISO Abbreviation: Clin Colorectal Cancer Subsets: MEDLINE |
| Imprint Name(s): | Publication: : [New York] : Elsevier; Original Publication: Dallas, Tex. : Cancer Information Group, c2001- |
| MeSH Terms: | Anastomosis, Surgical/*methods ; Colonic Neoplasms/*surgery ; Intestinal Obstruction/*etiology ; Therapeutic Irrigation/*methods; Anastomotic Leak/epidemiology ; Colonic Neoplasms/diagnosis ; Colostomy/methods ; Intestinal Obstruction/surgery ; Intraoperative Care/methods ; Laparotomy/methods ; Postoperative Complications/epidemiology ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged |
| Abstract: | Background: The management of obstructive left colon cancer (OLCC) remains debatable with the single-stage procedure of primary colonic anastomosis after cancer resection and on-table intracolonic lavage now being supported.; Patients and Methods: Patients with acute OLCC who were admitted between January 2008 and January 2015 were distributed into 5 different groups. Group ICI underwent emergency laparotomy for primary anastomosis following colonic resection and intraoperative colonic lavage; Group HP underwent emergency Hartmann's Procedure; Group CON consisted of patients treated by conservative management with subsequent elective open cancer resection; Group COL were colostomy patients; and Group INT consisted of patients who had interventional radiology followed by open elective colon cancer resection. The demographics of the patients and comorbidity, intraoperative data, and postoperative data were collected, with P < .05 as significant.; Results: There were 4 deaths in 138 cases (2.90%). There was only 1 patient who had anastomotic leakage (5.56%) in Group ICI, compared with none in Group HP and Group COL, 1 case in Group INT (7.69%), and 2 cases in Group CON (6.06%) (P > .05). Group INT and Group CON, when compared to the three surgical groups, Groups ICI, Group COL, and Group HP, individually, were statistically significant for the duration of surgery (P < .05).; Conclusions: Primary anastomosis following colonic resection after irrigation can be safely performed in selected patients, with the necessary surgical expertise, with no increased risk in mortality, anastomotic leakage, and other postoperative complications.; (Copyright © 2017 Elsevier Inc. All rights reserved.) |
| Contributed Indexing: | Keywords: Colonic lavage; Hartmann's procedure; Segmental colectomy; Self-expanding metallic stenting; Trans-anal drainage tube |
| Entry Date(s): | Date Created: 20170304 Date Completed: 20180306 Latest Revision: 20180520 |
| Update Code: | 20260130 |
| DOI: | 10.1016/j.clcc.2016.12.001 |
| PMID: | 28254356 |
| Database: | MEDLINE |
Comparative Study; Journal Article