Short- and Long-term Outcomes of One-stage Radical Resection and Anastomosis without Preoperative Decompression and Diverting Stoma between Incomplete Obstructive and Non-obstructive Left-sided Colorectal Cancer: A Retrospective Observational Study
Objectives: This study aimed to evaluate the safety and long-term outcomes of a one-stage resection and anastomosis approach without preoperative decompression in patients with left-sided incomplete obstructive colorectal cancer. Methods: We conducted a retrospective analysis of 571 patients diagnos...
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| Format: | Article |
| Language: | English |
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The Japan Society of Coloproctology
2025-01-01
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| Series: | Journal of the Anus, Rectum and Colon |
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| Online Access: | https://www.jstage.jst.go.jp/article/jarc/9/1/9_2024-076/_pdf/-char/en |
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| author | Kentaro Sato Yosuke Fukunaga Manabu Takamatsu Tatsuki Noguchi Takashi Sakamoto Shimpei Matsui Toshiki Mukai Tomohiro Yamaguchi Takashi Akiyoshi |
| author_facet | Kentaro Sato Yosuke Fukunaga Manabu Takamatsu Tatsuki Noguchi Takashi Sakamoto Shimpei Matsui Toshiki Mukai Tomohiro Yamaguchi Takashi Akiyoshi |
| author_sort | Kentaro Sato |
| collection | DOAJ |
| description | Objectives: This study aimed to evaluate the safety and long-term outcomes of a one-stage resection and anastomosis approach without preoperative decompression in patients with left-sided incomplete obstructive colorectal cancer.
Methods: We conducted a retrospective analysis of 571 patients diagnosed with pT3-4NanyM0 left-sided colorectal cancer who underwent radical resection and primary anastomosis without preoperative decompression or a diverting stoma from April 2012 to December 2019. Of these, 97 (17%) patients presented with incomplete obstruction, while 474 (83%) had no obstruction. Incomplete obstruction was characterized by the inability of a small-caliber endoscope to pass through the tumor without necessitating emergency surgery or decompression due to bowel obstruction. We compared perioperative short-term outcomes, as well as the 5-year overall survival rate and the 5-year relapse-free survival rate between the two groups.
Results: Patients in the incomplete obstruction group experienced significantly longer median intervals between admission and surgery (6 vs. 2 days, P<0.001), higher complication rates (25.8% vs. 15%, P=0.016), and longer median postoperative hospital stays (10 vs. 9 days, P=0.002). However, the rates of anastomotic leakage (2.1% vs. 2.3%, P=1), the 5-year overall survival (91.5% vs. 93.7%, P=0.436), and the 5-year relapse-free survival (80.2% vs. 85.6%, P=0.195) were comparable between the groups.
Conclusions: The outcomes regarding anastomotic leakage and long-term survival for one-stage resection and anastomosis without preoperative decompression in cases of incomplete obstructive colorectal cancer are promising. This management strategy appears feasible and safe with appropriate preoperative bowel preparation. |
| format | Article |
| id | doaj-art-a8de4172e94e4ad98ae4a81cf0009369 |
| institution | Kabale University |
| issn | 2432-3853 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | The Japan Society of Coloproctology |
| record_format | Article |
| series | Journal of the Anus, Rectum and Colon |
| spelling | doaj-art-a8de4172e94e4ad98ae4a81cf00093692025-01-27T10:02:40ZengThe Japan Society of ColoproctologyJournal of the Anus, Rectum and Colon2432-38532025-01-0191415110.23922/jarc.2024-0762024-076Short- and Long-term Outcomes of One-stage Radical Resection and Anastomosis without Preoperative Decompression and Diverting Stoma between Incomplete Obstructive and Non-obstructive Left-sided Colorectal Cancer: A Retrospective Observational StudyKentaro Sato0Yosuke Fukunaga1Manabu Takamatsu2Tatsuki Noguchi3Takashi Sakamoto4Shimpei Matsui5Toshiki Mukai6Tomohiro Yamaguchi7Takashi Akiyoshi8Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer ResearchDepartment of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer ResearchDepartment of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer ResearchDepartment of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer ResearchDepartment of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer ResearchDepartment of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer ResearchDepartment of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer ResearchDepartment of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer ResearchDepartment of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer ResearchObjectives: This study aimed to evaluate the safety and long-term outcomes of a one-stage resection and anastomosis approach without preoperative decompression in patients with left-sided incomplete obstructive colorectal cancer. Methods: We conducted a retrospective analysis of 571 patients diagnosed with pT3-4NanyM0 left-sided colorectal cancer who underwent radical resection and primary anastomosis without preoperative decompression or a diverting stoma from April 2012 to December 2019. Of these, 97 (17%) patients presented with incomplete obstruction, while 474 (83%) had no obstruction. Incomplete obstruction was characterized by the inability of a small-caliber endoscope to pass through the tumor without necessitating emergency surgery or decompression due to bowel obstruction. We compared perioperative short-term outcomes, as well as the 5-year overall survival rate and the 5-year relapse-free survival rate between the two groups. Results: Patients in the incomplete obstruction group experienced significantly longer median intervals between admission and surgery (6 vs. 2 days, P<0.001), higher complication rates (25.8% vs. 15%, P=0.016), and longer median postoperative hospital stays (10 vs. 9 days, P=0.002). However, the rates of anastomotic leakage (2.1% vs. 2.3%, P=1), the 5-year overall survival (91.5% vs. 93.7%, P=0.436), and the 5-year relapse-free survival (80.2% vs. 85.6%, P=0.195) were comparable between the groups. Conclusions: The outcomes regarding anastomotic leakage and long-term survival for one-stage resection and anastomosis without preoperative decompression in cases of incomplete obstructive colorectal cancer are promising. This management strategy appears feasible and safe with appropriate preoperative bowel preparation.https://www.jstage.jst.go.jp/article/jarc/9/1/9_2024-076/_pdf/-char/encolorectal cancerobstructionincomplete obstructionanastomosisoutcomes |
| spellingShingle | Kentaro Sato Yosuke Fukunaga Manabu Takamatsu Tatsuki Noguchi Takashi Sakamoto Shimpei Matsui Toshiki Mukai Tomohiro Yamaguchi Takashi Akiyoshi Short- and Long-term Outcomes of One-stage Radical Resection and Anastomosis without Preoperative Decompression and Diverting Stoma between Incomplete Obstructive and Non-obstructive Left-sided Colorectal Cancer: A Retrospective Observational Study Journal of the Anus, Rectum and Colon colorectal cancer obstruction incomplete obstruction anastomosis outcomes |
| title | Short- and Long-term Outcomes of One-stage Radical Resection and Anastomosis without Preoperative Decompression and Diverting Stoma between Incomplete Obstructive and Non-obstructive Left-sided Colorectal Cancer: A Retrospective Observational Study |
| title_full | Short- and Long-term Outcomes of One-stage Radical Resection and Anastomosis without Preoperative Decompression and Diverting Stoma between Incomplete Obstructive and Non-obstructive Left-sided Colorectal Cancer: A Retrospective Observational Study |
| title_fullStr | Short- and Long-term Outcomes of One-stage Radical Resection and Anastomosis without Preoperative Decompression and Diverting Stoma between Incomplete Obstructive and Non-obstructive Left-sided Colorectal Cancer: A Retrospective Observational Study |
| title_full_unstemmed | Short- and Long-term Outcomes of One-stage Radical Resection and Anastomosis without Preoperative Decompression and Diverting Stoma between Incomplete Obstructive and Non-obstructive Left-sided Colorectal Cancer: A Retrospective Observational Study |
| title_short | Short- and Long-term Outcomes of One-stage Radical Resection and Anastomosis without Preoperative Decompression and Diverting Stoma between Incomplete Obstructive and Non-obstructive Left-sided Colorectal Cancer: A Retrospective Observational Study |
| title_sort | short and long term outcomes of one stage radical resection and anastomosis without preoperative decompression and diverting stoma between incomplete obstructive and non obstructive left sided colorectal cancer a retrospective observational study |
| topic | colorectal cancer obstruction incomplete obstruction anastomosis outcomes |
| url | https://www.jstage.jst.go.jp/article/jarc/9/1/9_2024-076/_pdf/-char/en |
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