Abstract:
PURPOSE:This study evaluated a better treatment for patients with obstructive colorectal cancer (CRC) that have a poor prognosis. METHOD:This study compared the outcomes of 138 patients with obstructive CRC, including 70 primary resections, 50 resections after bowel decompression using an ileus tube, and 18 delayed resections after colostomy. RESULTS:The ileus tube and delayed resection groups included more left-sided primary lesions. The physiologic POSSUM, types 3-4, tumor size, CEA, and hospital stay of the delayed resection group were different, in comparison to both the primary resection and ileus tube groups. The histopathological type and depth of invasion of the delayed resection group included less well types and more T4 than those of the ileus tube group. The operative blood loss of the delayed resection group was more than that of the ileus tube group. There were no differences in the overall and disease-free survival among the three groups. CONCLUSION:Separately analyzing the data of the right-sided cancer group and the left-sided cancer group demonstrated that primary resection might be acceptable for right-sided obstructive CRC and delayed resection might be done for patients with poorer general conditions (high PPS) and poorer oncological prognostic factors such as more type 3/type 4 cases, a larger tumor size, a less well-differentiated histopathological type, more T4 cases, and a higher CEA level.
journal_name
Surg Todayjournal_title
Surgery todayauthors
Hotta T,Takifuji K,Kobayashi Y,Tabuse K,Shimada K,Maeda T,Nakatani Y,Fukiage O,Yamaue Hdoi
10.1007/s00595-011-0116-2subject
Has Abstractpub_date
2012-12-01 00:00:00pages
1154-64issue
12eissn
0941-1291issn
1436-2813journal_volume
42pub_type
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