Ann Coloproctol > Volume 38(3); 2022 > Article |
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Level of oral intake | Score |
---|---|
Requiring continuous decompressive procedure | 0 |
No oral intake | 1 |
Liquid or enteral nutrient | 2 |
Soft solids, low-residue, and full diet with symptoms of stricture | 3 |
Soft solids, low-residue, and full diet without symptoms of stricturea | 4 |
a Symptoms of stricture contain abdominal pain/cramps, abdominal distension, nausea, vomiting, constipation, and diarrhea which are related to gastrointestinal transit.
Adapted from Saida [15], according to the Creative Commons License.
Characteristic | Surgery alone (n = 65) | Bridge to surgery (n = 43) | P-value |
---|---|---|---|
Sex | 0.422 | ||
Male | 42 (64.6) | 24 (55.8) | |
Female | 23 (35.4) | 19 (44.2) | |
Age (yr) | 72 (31−92) | 69 (39−90) | 0.466 |
Body mass index (kg/m2) | 21.5 (13.7−29.4) | 20.3 (14.6−28.4) | 0.496 |
ASA PS classification | 0.674 | ||
I | 21 (32.3) | 12 (27.9) | |
II, III | 44 (67.7) | 31 (72.1) | |
The score of CROSS | 0.269 | ||
0−2 | 58 (89.2) | 35 (81.4) | |
3, 4 | 7 (10.8) | 8 (18.6) | |
Bowel decompressiona | 23 (35.4) | 43 (100) | < 0.001c |
Duration of decompression (days)b | 9 (0−30) | 18 (10−67) | < 0.001c |
Types of stent | - | ||
WallFlex Colonic Stent | NA | 16 (37.2) | |
HANAROSTENT Naturfit | NA | 7 (16.3) | |
Niti-S | NA | 20 (46.5) | |
Tumor location | 0.304 | ||
Left-sided | 40 (61.5) | 31 (72.1) | |
Right-sided | 25 (38.5) | 12 (27.9) | |
Tumor size (cm) | 5.5 (2.5−13.5) | 5.6 (3.5−10.5) | 0.975 |
pT category | 0.198 | ||
pT2−3 | 49 (75.4) | 27 (62.8) | |
pT4 | 16 (24.6) | 16 (37.2) | |
pN category | 0.548 | ||
pN0 | 38 (58.5) | 28 (65.1) | |
pN1, 2 | 27 (41.5) | 15 (34.9) | |
Histological type | |||
Well or moderately differentiated tubular adenocarcinoma | 60 (92.3) | 43 (100) | 0.155 |
Others | 5 (7.7) | 0 (0) | |
Venous invasion | 0.542 | ||
V0 | 26 (40.0) | 14 (32.6) | |
V1, 2 | 39 (60.0) | 29 (67.4) | |
Lymphatic invasion | 0.212 | ||
Ly0 | 40 (61.5) | 32 (74.4) | |
Ly1, 2 | 25 (38.5) | 11 (25.6) |
Values are presented as number (%) or median (range).
ASA, American Society of Anesthesiologists; PS, physical status; CROSS, The ColoRectal Obstruction Scoring System; NA, not applicable.
WallFlex Colonic Stent: Boston Scientific Corp., Marlborough, MA, USA; HANAROSTENT Naturfit: Boston Scientific Corp.; Niti-S: Taewoong Medical, Gimpo, Korea.
a Bowel decompression was defined as non-nonsurgical procedures by a nasal ileus tube, nasogastric tube or colonic stent.
Variable | Surgery alone (n = 65) | Bridge to surgery (n = 43) | P-value |
---|---|---|---|
Emergency surgery | 19 (29.2) | 1 (2.3) | < 0.001a |
Surgical approach | 0.006a | ||
Open | 41 (63.1) | 15 (34.9) | |
Laparoscopic | 24 (36.9) | 28 (65.1) | |
Stoma creation during curative resection | 11 (16.9) | 2 (4.7) | 0.072 |
Number No. of dissection lymph nodes | 21 (3−113) | 25 (8−57) | 0.418 |
Resection status of lymph node | 0.120 | ||
D1 | 6 (9.2) | 0 (0) | |
D2 | 15 (23.1) | 9 (20.9) | |
D3 | 44 (67.7) | 34 (79.1) | |
Operative time (min) | 187 (109−596) | 228 (138−343) | < 0.001a |
Blood loss (g) | 80 (0−3,110) | 10 (5−1,430) | 0.362 |
POD until gas or stool discharge | 2 (0−9) | 2 (0−18) | 0.736 |
POD until oral intake starting | 4 (2−18) | 4 (3−20) | 0.918 |
Postoperative hospital stay (days) | 11 (6−64) | 9 (6−30) | 0.020a |
Postoperative complications | 18 (27.7) | 11 (25.6) | > 0.999 |
CD grade I−II | 15 (23.1) | 7 (16.3) | 0.375 |
CD grade III−V | 3 (4.6) | 4 (9.3) | |
Ileus | 3 (4.6) | 4 (9.3) | |
Intraperitoneal abscess | 4 (6.2) | 1 (2.3) | |
Anastomotic leak | 2 (3.1) | 0 (0) | |
Wound infection | 3 (4.6) | 3 (7.0) | |
Cardiovascular event | 1 (1.5) | 0 (0) | |
Cerebrovascular event | 1 (1.5) | 0 (0) | |
Others | 4 (6.0) | 3 (7.0) |
Variable | Surgery alonea (n = 65) | Bridge to surgery (n = 43) | HR (95% CI)b | P-value |
---|---|---|---|---|
Any recurrences | 10 (15.4) | 12 (27.9) | 2.22 (0.95−5.19) | 0.066 |
Locoregional recurrences | 6 (9.2) | 3 (7.0) | 1.05 (0.26−4.29) | 0.948 |
Anastomotic | 0 (0) | 1 (2.3) | ||
Peritoneum | 5 (7.7) | 3 (7.0) | ||
Pelvic lymph node | 1 (1.5) | 0 (0) | ||
Distant metastatic recurrences | 7 (10.8) | 11 (25.6) | 2.67 (1.03−6.91) | 0.043c |
Liver | 1 (1.5) | 6 (14.0) | ||
Lung | 3 (4.6) | 3 (7.0) | ||
Para-aortic lymph node | 2 (3.1) | 1 (2.3) | ||
Ovary | 1 (1.5) | 1 (2.3) |