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- 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, Jae Hwang Kim
- Ann Coloproctol. 2014;30(6):251-258. Published online December 31, 2014
- DOI: https://doi.org/10.3393/ac.2014.30.6.251
- 5,728 View
- 47 Download
- 5 Web of Science
- 4 Citations
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Abstract
PDF 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.
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Citations
Citations to this article as recorded by
- Associated factors for postoperative morbidity and mortality following surgery of obstructive colon tumors
Mseddi Mohamed Ali, Siala Rakia, Yakoubi Chaima, Hsairi Mariem, Hssin Hajer, Krifa Nesrine, Trifa Fatma, Boubaker Radhia, Sallemi Karim, Khemakhem Emna, Mghirbi Abdelwaheb, Bhira Amal, Yosra Yahia, Mestiri Souhir, Guizeni Rami, Ghariani Brahim, Sassi Kari
F1000Research.2025; 14: 875. CrossRef - Clinical characteristics and risk factors of post-operative intestinal flora disorder following laparoscopic colonic surgery: A propensity-score-matching analysis
Gan-Bin Li, Chen-Tong Wang, Xiao Zhang, Xiao-Yuan Qiu, Wei-Jie Chen, Jun-Yang Lu, Lai Xu, Bin Wu, Yi Xiao, Guo-Le Lin
World Journal of Gastrointestinal Surgery.2024; 16(5): 1259. CrossRef - Laparoscopic versus open surgery for obese patients with rectal cancer: a retrospective cohort study
Hiroyuki Matsuzaki, Soichiro Ishihara, Kazushige Kawai, Koji Murono, Kensuke Otani, Koji Yasuda, Takeshi Nishikawa, Toshiaki Tanaka, Tomomichi Kiyomatsu, Keisuke Hata, Hiroaki Nozawa, Hironori Yamaguchi, Toshiaki Watanabe
Surgery Today.2017; 47(5): 627. CrossRef - Surgical Treatment of Obstructed Left-Sided Colorectal Cancer Patients
Young Jin Kim
Annals of Coloproctology.2014; 30(6): 245. CrossRef
- Associated factors for postoperative morbidity and mortality following surgery of obstructive colon tumors
- The Characteristics and Prognosis of Patients with Obstructing Carcinoma of the Left Colon and Rectum: A Case-Control Study.
- Lee, In Taek , Choi, Gyu Seog , Lee, Jong Ho
- J Korean Soc Coloproctol. 2004;20(5):303-310.
- 1,359 View
- 5 Download
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Abstract
PDF
- PURPOSE
Many reports have described significantly lower survival rates for patients with obstructing colorectal cancer than for patients with non-obstructing colorectal cancer. The aim of this retrospective study was to assess the long-term prognosis of patients with obstructing carcinomas of the left colon and rectum and to identify the clinical and pathologic characteristics that affect the prognosis.
METHODS
From June 1996 to October 2003, 46 patients with obstructing left colon and rectal cancer underwent curative surgery (case group), and from the patients with non- obstructing left colon and rectal cancer who had curative surgery, 48 patients with clinicopathologic characteristics similar to those of the case group were selected and matched as a control group. A comparative analysis of demographic, clinical, and pathologic characteristics, the recurrence rate, and the long-term survival rate between these two groups was done.
RESULTS
Emergency operations were done more frequently for obstructing cancer than for non-obstructing cancer (P=0.0001), and more patients with obstructing cancer presented to non-specialists (P=0.0001). The overall recurrence rate was significantly higher in obstructing cancer patients than in non-obstructing cancer patients. Further, the 5-year overall and the disease-free survival rates were significantly lower in obstructing cancer patients when examining either overall patient outcome or stage-III patients outcome.
CONCLUSIONS
The long-term prognosis of patients with obstructing carcinomas of the left colon and rectum is poor. We suggest that the poor general condition of patients with obstructing cancer, the increased number of emergency operations involving those patients, and more patients with obstructing cancer presenting to non-specialists may contribute to poor long-term prognosis for obstructing cancer patients.
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