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Colorectal Service, Department of General Surgery, Sengkang General Hospital, Singapore
© 2024 The Korean Society of Coloproctology
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflict of interest
Frederick H. Koh is an Editorial Board member of Annals of Coloproctology, but was not involved in the reviewing or decision process of this manuscript. No other potential conflict of interest relevant to this article was reported.
Funding
None.
Author contributions
Conceptualization: all authors; Data curation: MSQK; Investigation: MSQK; Methodology: MSQK; Visualization: all authors; Writing–original draft: MSQK, FHK; Writing–review & editing: all authors. All authors read and approved the final manuscript.
Additional information
This study was presented as a poster presentation at the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 2023 Annual Meeting on March 29–April 1, 2023, in Montreal, Canada; and at the 19th Congress of the Asia Pacific Federation of Coloproctology (APFCP) on October 19–21, 2023, in Singapore.
Outcome | Value (n=29) |
---|---|
Technical success | 26 (90) |
Clinical success | 24 (83) |
Stent complication | |
Perforation | 3 (10) |
Migration | 0 (0) |
Time to surgery (day) | 13 (9–17) |
Type of definitive surgery | |
Open surgery | 8 (28) |
Laparoscopic surgery | 21 (72) |
Primary anastomosis | |
Without stoma | 24 (83) |
With stoma | 3 (10) |
Time to first bowel motion (day) | 3 (2–4) |
Procedure time (min) | 226 (189–271) |
Overall postoperative complication | 4 (14) |
Clavien-Dindo classification | |
I | 0 (0) |
II | 1 (3) |
III | 2 (7) |
IV | 1 (3) |
30-day Mortality | 0 (0) |
Adjuvant chemotherapya | 15 (56) |
Variable | Length of hospital stay (day) |
---|---|
High-dependency care | 1 (1–1) |
General ward | 7 (5–13.5) |
Total | 8 (6–14.5) |
Cost (USD) | Colonic stenting | Emergency surgery |
---|---|---|
Index admission | ||
Bed | 1,075a | 3,367b |
Stent | 1,339 | - |
Surgical cost | 5,434 | 35,778 |
Stoma supply | - | 385 |
Second admission | ||
Bed | 3,009 | 1,433 |
Surgical cost | 19,056c | 5,470d |
Total | 29,913 | 46,433 |
Variable | Value (n=29) |
---|---|
Demographic | |
Age (yr) | 66 (57–71) |
ASA physical status | |
I | 2 (7) |
II | 21 (69) |
III | 5 (17) |
IV | 1 (3) |
Pathological cause | |
Malignant cause of obstruction | 27 (93) |
Length of symptoms (day) | 2 (3–7) |
TNM stagea | |
II | 17 (63) |
III | 6 (22) |
IV | 4 (15) |
Lymphovascular invasiona | 13 (48) |
Perineural invasiona | 10 (37) |
Tumor location | |
Transverse colon | 1 (3) |
Splenic flexure | 1 (3) |
Descending colon | 8 (28) |
Sigmoid | 19 (66) |
Outcome | Value (n=29) |
---|---|
Technical success | 26 (90) |
Clinical success | 24 (83) |
Stent complication | |
Perforation | 3 (10) |
Migration | 0 (0) |
Time to surgery (day) | 13 (9–17) |
Type of definitive surgery | |
Open surgery | 8 (28) |
Laparoscopic surgery | 21 (72) |
Primary anastomosis | |
Without stoma | 24 (83) |
With stoma | 3 (10) |
Time to first bowel motion (day) | 3 (2–4) |
Procedure time (min) | 226 (189–271) |
Overall postoperative complication | 4 (14) |
Clavien-Dindo classification | |
I | 0 (0) |
II | 1 (3) |
III | 2 (7) |
IV | 1 (3) |
30-day Mortality | 0 (0) |
Adjuvant chemotherapy |
15 (56) |
Surgical outcome | Colonic stenting (n=29) | Emergency surgery (n=63) |
---|---|---|
Emergency operation | 5 (17) | 63 (100) |
Surgery type | ||
Open surgery | 8 (28) | 63 (100) |
Laparoscopic surgery | 21 (72) | 0 (0) |
Stoma required | 5 (17) | 42 (67) |
Stoma reversed | 0/5 (0) | 16/42 (38) |
Variable | Length of hospital stay (day) |
---|---|
High-dependency care | 1 (1–1) |
General ward | 7 (5–13.5) |
Total | 8 (6–14.5) |
Cost (USD) | Colonic stenting | Emergency surgery |
---|---|---|
Index admission | ||
Bed | 1,075 |
3,367 |
Stent | 1,339 | - |
Surgical cost | 5,434 | 35,778 |
Stoma supply | - | 385 |
Second admission | ||
Bed | 3,009 | 1,433 |
Surgical cost | 19,056 |
5,470 |
Total | 29,913 | 46,433 |
Cost (USD) | Colonic stenting | Emergency surgery |
---|---|---|
Success | ||
With stoma | ||
Reversed | 36,816 | 46,433 |
Not reversed | 30,298 | 39,529 |
Without stoma | 29,913 | 39,145 |
Failure | - | |
With stoma | ||
Reversed | 54,281 | |
Not reversed | 47,377 | |
Without stoma | 46,992 |
Values are presented as median (interquartile range) or number (%). ASA, American Society of Anesthesiologists. aAmong 27 malignant cases.
Values are presented as number (%) or median (interquartile range). Among 27 malignant cases.
Values are presented as number (%).
Values are presented as median (interquartile range).
Colonic stenting, obstructed tumor with definitive surgery without stoma. Emergency surgery, obstructed tumor with subsequent stoma reversal. Three-day stay. Nine-day stay. Definitive surgery. Stoma reversal.