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. 2014 Dec;30(6):251-8.
doi: 10.3393/ac.2014.30.6.251. Epub 2014 Dec 31.

Comparative study of postoperative complications in patients with and without an obstruction who had left-sided colorectal cancer and underwent a single-stage operation after mechanical bowel preparation

Sang Hun Jung  1 , Jae Hwang Kim  1
Affiliations

Comparative study of postoperative complications in patients with and without an obstruction who had left-sided colorectal cancer and underwent a single-stage operation after mechanical bowel preparation

Sang Hun Jung et al. Ann Coloproctol. 2014 Dec.

Abstract

Purpose: The purpose of this study is to compare postoperative complications for single-stage surgery after mechanical bowel preparation in patients who experienced obstruction and those who did not.

Methods: From 2000 to 2011, 1,224 patients underwent a single-stage operation for left colorectal cancer after bowel preparation. Nonobstruction (NOB) and obstruction (OB) colorectal cancer patients were 1,053 (86.0%) and 171 (14.0%), respectively. Postoperative morbidity and mortality were compared between groups.

Results: The OB group had poor preoperative conditions (age, white blood cell, hemoglobin, albumin level, and advanced tumor stage) compared with the NOB group (P < 0.05). Mean on-table lavage time for the OB group was 17.5 minutes (range, 14-60 minutes). Mean operation time for the OB group was statistically longer than that of the NOB group (OB: 210 minutes; range, 120-480 minutes vs. NOB: 180 minutes; range, 60-420 minutes; P < 0.001). Overall morbidity was similar between groups (NOB: 19.7% vs. OB: 23.4%, P = 0.259). Major morbidity was more common in the OB group than in the NOB group, but the difference was without significance (OB: 11.7% vs. NOB: 7.6%, P = 0.070). Postoperative death occurred in 16 patients (1.3%), and death in the OB group (n = 7) was significantly higher than it was in the NOB group (n = 9) (4.1% vs. 0.9%, P = 0.001). Twelve patients had surgical complications, which were the leading cause of postoperative death: postoperative bleeding in five patients and leakage in seven patients.

Conclusion: Postoperative morbidity for a single-stage operation for obstructive left colorectal cancer is comparable to that for NOB, regardless of poor conditions of the patient.

Keywords: Left colorectal cancer; Morbidity; Mortality; Obstruction; Single-stage operation.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

References

    1. Gainant A. Emergency management of acute colonic cancer obstruction. J Visc Surg. 2012;149:e3–e10. - PubMed
    1. Ansaloni L, Andersson RE, Bazzoli F, Catena F, Cennamo V, Di Saverio S, et al. Guidelenines in the management of obstructing cancer of the left colon: consensus conference of the world society of emergency surgery (WSES) and peritoneum and surgery (PnS) society. World J Emerg Surg. 2010;5:29. - PMC - PubMed
    1. Tan KK, Sim R. Surgery for obstructed colorectal malignancy in an Asian population: predictors of morbidity and comparison between left- and right-sided cancers. J Gastrointest Surg. 2010;14:295–302. - PubMed
    1. Villar JM, Martinez AP, Villegas MT, Muffak K, Mansilla A, Garrote D, et al. Surgical options for malignant left-sided colonic obstruction. Surg Today. 2005;35:275–281. - PubMed
    1. Driest JJ, Zwaving HH, Ledeboer M, Eeftinck Schattenkerk M, Kuipers EJ, Ter Borg F. Low morbidity and mortality after stenting for malignant bowel obstruction. Dig Surg. 2011;28:367–371. - PubMed

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