Annals of Coloproctology

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Original Article

Benign proctology,Rare disease & stoma,Surgical technique

Comparison of blowhole colostomy and loop ostomy for palliation of acute malignant colonic obstruction: Yongjun Park, Dong Uk Choi, Hyung Ook Kim, Yong Bog Kim, Chungki Min, Jung Tack Son, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim; Ann Coloproctol. 2022;38(4):319-326. Published online March 7, 2022; DOI: https://doi.org/10.3393/ac.2021.00682.0097

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2 Web of Science
3 Citations

Purpose
Surgery to create a stoma for decompression might be required for unresectable stage IV cancer patients with complete colonic obstruction. The aim of this study was to compare the results of blowhole colostomy with those of loop ostomy.
Methods
Palliative ileostomy or colostomy procedures performed at a single center between January 2011 and October 2020, were analyzed retrospectively. Fifty-nine patients were identified during this period. The demographic characteristics and outcomes between the blowhole colostomy group (n=24) and the loop ostomy group (n=35) were compared.
Results
The median operative time tended to be shorter in the blowhole colostomy group (52.5 minutes; interquartile range [IQR], 43–65) than in the loop ostomy group (60 minutes; IQR, 40–107), but the difference did not reach statistical significance (P=0.162). The median length of hospital stay was significantly shorter with blowhole colostomy (blowhole, 13 days [IQR, 9–23]; loop, 21 days [IQR, 14–37]; P=0.013). Mean cecum diameter was significantly larger in the blowhole group than in the loop group (8.83±1.91 cm vs. 6.78±2.36 cm, P=0.001), and the emergency operation rate was higher in the blowhole group than in the loop group (22 of 24 [91.7%] vs. 23 of 35 [65.7%], P=0.021).
Conclusion
In surgical emergencies, diverting a blowhole colostomy can be safe and effective for palliative management of colonic obstruction in patients with end-stage cancer and might reduce the operative time in emergent situations.

Citations

Citations to this article as recorded by

A Last Resort: Dacron Vascular Graft Prosthesis for Management of a Blowhole Colostomy
Brittney A. Ehrlich, Maria C. Unuvar, Justin M. Orenich, Rebecca L. Hoffman
The American Surgeon™.2025; 91(2): 303. CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef
Stoma-Related Complications: A Single-Center Experience and Literature Review
Zalán Benedek, Loránd Kocsis, Orsolya Bauer, Nicolae Suciu, Sorin Sorlea, Călin Crăciun, Rareș Georgescu, Marius Florin Coroș
Journal of Interdisciplinary Medicine.2022; 7(2): 31. CrossRef

Case Report

Malignant disease

Nasal Cavity Metastasis From Colorectal Cancer Represents End-Stage Disease and Should Be Palliated: Stephen Hwang, Dedrick Kok Hong Chan, Fredrik Petersson, Ker-Kan Tan; Ann Coloproctol. 2020;36(2):119-121. Published online November 13, 2019; DOI: https://doi.org/10.3393/ac.2019.03.04

5,846 View
112 Download
5 Web of Science
6 Citations

Abstract PDF

Nasal metastases from colorectal cancer is rare. The presentation of nasal metastases is often very similar to primary nasal sinus adenocarcinoma. A high index of suspicion is required, especially in patients who have had a previous history of colorectal carcinoma. Histology is ultimately required for diagnosis. We describe 2 cases of nasal metastases from colorectal carcinoma, and discuss the presentation, diagnosis and management of the case. Such metastatic disease ultimately represents end-stage malignancy, and patients should be palliated.

Citations

Citations to this article as recorded by

Metastatic sinonasal malignancies of colorectal origin: Case report and comprehensive review of the literature
Andrew J. Rothka, David Goldrich, Jessyka G. Lighthall
Clinical Case Reports.2024;[Epub] CrossRef
Surgical treatment for metastatic colorectal cancer
Eun Jung Park, Seung Hyuk Baik
Journal of the Korean Medical Association.2022; 65(9): 568. CrossRef
Recent Advance in the Surgical Treatment of Metastatic Colorectal Cancer-An English Version
Eun Jung Park, Seung Hyuk Baik
Journal of the Anus, Rectum and Colon.2022; 6(4): 213. CrossRef
A Very Rare Case of Metastases to the Nasal Cavity from Primary Rectal Adenocarcinoma
Nishant Lohia, Harish Sadashiva, Sankalp Singh, Samir Agarwal, Vikas Gupta, Manoj Prashar, Gaurav Trivedi
Clinical Cancer Investigation Journal.2022; 11(4): 1. CrossRef
Major driver mutations are shared between sinonasal intestinal-type adenocarcinoma and the morphologically identical colorectal adenocarcinoma
Sannia Sjöstedt, Ane Yde Schmidt, Filipe Garrett Vieira, Gro Linno Willemoe, Tina Klitmøller Agander, Caroline Olsen, Finn Cilius Nielsen, Christian von Buchwald
Journal of Cancer Research and Clinical Oncology.2021; 147(4): 1019. CrossRef
Rare case of metastatic adenocarcinoma to the maxillary sinus
Apurwa Prasad, Taha Alrifai, Sumathi Vijaya Rangan, Jessica Garcia
BMJ Case Reports.2021; 14(9): e244485. CrossRef

Review

Colorectal Cancer with Multiple Metastases: Is Palliative Surgery Needed?: Hong-Jo Choi, Jin Yong Shin; J Korean Soc Coloproctol. 2011;27(5):226-230. Published online October 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.5.226

4,514 View
31 Download
1 Citations

Abstract PDF

In patients with symptomatic incurable metastatic colorectal cancer (mCRC), the goal of resection of the primary lesion is to palliate cancer-related morbidity, including obstruction, bleeding, or perforation. In patients with asymptomatic primary tumors and incurable metastatic disease, however, the necessity of primary tumor resection is less clear. Although several retrospective analyses suggest survival benefit in patients who undergo resection of the primary tumor, applying this older evidence to modern patients is out of date for several reasons. Modern chemotherapy regimens incorporating the novel cytotoxic agents oxaliplatin and irinotecan, as well as the target agents bevacizumab and cetuximab, have improved median survival from less than 1 year with the only available single-agent 5-fluorouracil until the mid-1990s to over 2 years. In addition to significant prolongation of overall survival, combinations of novel chemotherapeutic and target agents have allowed improved local and distant tumor control, decreasing the likelihood of local tumor-related complications requiring surgical resection. Resection of an asymptomatic primary tumor risks surgical complications and may postpone the administration of chemotherapy that may offer both systemic and local control. In conclusion, the morbidity and the mortality of unnecessary surgery or surgery that does not improve quality of life or survival in patients with mCRC of a limited life expectancy should be carefully evaluated. With the availability of effective combinations of chemotherapy and target agents, systemic therapy for the treatment of life-threatening metastases would be a preferable treatment strategy for unresectable asymptomatic patients with mCRC.

Citations

Citations to this article as recorded by

Palliative laparoscopic bowel resection in stage IV colorectal cancer patients with unresectable metastasis
Kwan Mo Yang, Seok-Byung Lim, Yong Sik Yoon, Chan Wook Kim, In Ja Park, Chang Sik Yu, Jin Cheon Kim
Korean Journal of Clinical Oncology.2013; 9(2): 134. CrossRef

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