Standardization of surgical care for malignant colonic obstruction

Khirurgiia
Z A BagateliyaA V Gugnin

Abstract

To standardize surgical care for malignant colonic obstruction. There were 572 patients with malignant colonic obstruction: 247 of them were hospitalized in 2011-2013 (I group); 325 - in 2014-2017 (group II). Forty-six patients underwent medication; 302 - acute resection; 141 - stoma construction; 83 - stent deployment. Elective surgery and radiation or chemotherapy was performed after 0.5-6 months in 110 patients of group II. Acute resection was more common in I group, elective resection - in group II. Early and long-term results including Kaplan-Meier 3-year overall survival were compared in both groups. Complications occurred in 46.69% (group I) and 21% (group II). Postoperative mortality was significantly higher in group I compared with II group: 26.11 and 10.33%, respectively. Three-year overall survival was higher in group I compared with group II: 0.82 and 0.69, respectively. Advisability of new two-stage surgical standard is confirmed for malignant colonic obstruction. Stoma formation and stenting may be a valid alternative in some patients with malignant colonic obstruction due to significantly lower postoperative mortality.

References

Aug 17, 2011·Current Gastroenterology Reports·Christina A Tennyson, Carol E Semrad
Jul 20, 2012·Diseases of the Colon and Rectum·George J ChangUNKNOWN Standards Practice Task Force of the American Society of Colon and Rectal Surgeons
Jun 26, 2013·Digestive Diseases·Andrea May
Feb 5, 2016·World Journal of Gastrointestinal Surgery·Assad Zahid, Christopher John Young
Mar 11, 2016·World Journal of Gastrointestinal Endoscopy·Jayesh Sagar

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