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
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Online Access:http://www.sciencedirect.com/science/article/pii/S2773160X24000163
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author Jian Cui
Jinxin Shi
Hao Feng
Danian Tang
Xianglong Cao
Wenrui Xu
Zijian Li
Tao Yu
Chunlong Wang
Qi An
Gang Zhao
author_facet Jian Cui
Jinxin Shi
Hao Feng
Danian Tang
Xianglong Cao
Wenrui Xu
Zijian Li
Tao Yu
Chunlong Wang
Qi An
Gang Zhao
author_sort Jian Cui
collection DOAJ
description 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.
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spelling doaj-art-6adffcbfd1c740b7b0acb4daeffd2d242024-11-23T06:35:03ZengElsevierClinical Surgical Oncology2773-160X2024-06-0132100048Comparation of single or staged surgical management in acute obstructive non-metastatic colorectal cancer patients aged over 75Jian Cui0Jinxin Shi1Hao Feng2Danian Tang3Xianglong Cao4Wenrui Xu5Zijian Li6Tao Yu7Chunlong Wang8Qi An9Gang Zhao10Department of General Surgery,Department of Gastrointestinal Surgery,Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of General Surgery,Department of Gastrointestinal Surgery,Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, ChinaState Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, ChinaDepartment of General Surgery,Department of Gastrointestinal Surgery,Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of General Surgery,Department of Gastrointestinal Surgery,Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Radiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of General Surgery,Department of Gastrointestinal Surgery,Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of General Surgery,Department of Gastrointestinal Surgery,Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Pathophysiology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, ChinaDepartment of General Surgery,Department of Gastrointestinal Surgery,Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China; Corresponding author.Department of General Surgery,Department of Gastrointestinal Surgery,Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China; Corresponding author.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.http://www.sciencedirect.com/science/article/pii/S2773160X24000163Single surgeryStage surgeryAcute malignant colorectal obstructionsElderly patientsSelf-expandable metallic stents
spellingShingle Jian Cui
Jinxin Shi
Hao Feng
Danian Tang
Xianglong Cao
Wenrui Xu
Zijian Li
Tao Yu
Chunlong Wang
Qi An
Gang Zhao
Comparation of single or staged surgical management in acute obstructive non-metastatic colorectal cancer patients aged over 75
Clinical Surgical Oncology
Single surgery
Stage surgery
Acute malignant colorectal obstructions
Elderly patients
Self-expandable metallic stents
title Comparation of single or staged surgical management in acute obstructive non-metastatic colorectal cancer patients aged over 75
title_full Comparation of single or staged surgical management in acute obstructive non-metastatic colorectal cancer patients aged over 75
title_fullStr Comparation of single or staged surgical management in acute obstructive non-metastatic colorectal cancer patients aged over 75
title_full_unstemmed Comparation of single or staged surgical management in acute obstructive non-metastatic colorectal cancer patients aged over 75
title_short Comparation of single or staged surgical management in acute obstructive non-metastatic colorectal cancer patients aged over 75
title_sort comparation of single or staged surgical management in acute obstructive non metastatic colorectal cancer patients aged over 75
topic Single surgery
Stage surgery
Acute malignant colorectal obstructions
Elderly patients
Self-expandable metallic stents
url http://www.sciencedirect.com/science/article/pii/S2773160X24000163
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