Comparation of single or staged surgical management in acute obstructive non-metastatic colorectal cancer patients aged over 75

Comparation of single or staged surgical management in acute obstructive non-metastatic colorectal cancer patients aged over 75

Purpose: Management of obstructive colorectal cancer (OCRC) can be achieved through either emergent resection of the primary tumor (single operation), or the creation of temporary decompression stoma or self-expandable metallic stents (SEMS) insertion followed by tumor resection (staged procedure)....

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Main Authors: Jian Cui, Jinxin Shi, Hao Feng, Danian Tang, Xianglong Cao, Wenrui Xu, Zijian Li, Tao Yu, Chunlong Wang, Qi An, Gang Zhao
Format: Article
Language:English
Published: Elsevier 2024-06-01
Series:Clinical Surgical Oncology
Subjects:
Single surgery
Stage surgery
Acute malignant colorectal obstructions
Elderly patients
Self-expandable metallic stents
Online Access:http://www.sciencedirect.com/science/article/pii/S2773160X24000163
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Summary:Purpose: Management of obstructive colorectal cancer (OCRC) can be achieved through either emergent resection of the primary tumor (single operation), or the creation of temporary decompression stoma or self-expandable metallic stents (SEMS) insertion followed by tumor resection (staged procedure). The aim of the study was to compare the short-term outcomes of single and staged surgery in acute non-metastatic elderly OCRC patients. Methods: Twenty-two elderly patients (aged over 75) scheduled to receive either single surgery (n ​= ​14) or staged surgery (n ​= ​8) for the management of acute OCRC were enrolled from 2012 to 2017. The stoma rate, postoperative complications were compared. Results: The stoma rate was 42.9% in single surgery group and 25% in SEMS group. No difference was found in the rate of total complications (50% vs 25%, P ​= ​0.25). In the single surgery group, four patients (28.6%) experienced SSIs, and pneumonia occurred in three patients (21.4%), whereas none of the patient in staged surgery had infection related complication. Overall, the rate of infection related complication in single surgery group (50%) was significantly higher than that in staged surgery group (P ​= ​0.015). Conclusions: Either single or stage surgery is feasible for acute elderly OCRC patients. However, single surgery is associated with significant increase in infection related complication.
ISSN:2773-160X

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