| Self-expanding metallic stent as a bridge to surgery versus emergency resection for obstructing left-sided colorectal cancer: a case-matched study. | |
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MedLine Citation:
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PMID: 16769535 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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This study aimed to compare the outcomes of patients who suffered from obstructing left-sided colorectal cancer, treated with self-expanding metallic stent (SEMS) as a bridge to surgery, with those who underwent emergency operation. Twenty patients who had acute obstruction due to left-sided colorectal cancer underwent surgical resection after insertion of SEMS (group I) were matched to 40 patients with emergency colonic resection (group II). The two groups were compared for the incidence of primary anastomosis, stoma rate, hospital stay, duration of intensive care, postoperative morbidity, and mortality. Both groups had similar preoperative comorbidity and stage of disease, but the tumors in group I were more distally located (P < 0.001). In group I, one patient developed colon perforation and required Hartmann's operation. All the other patients underwent elective operation with primary anastomosis. In group II, primary anastomosis was performed in 29 patients (72.5%; P = 0.047). The operative mortality of group I and group II was 5% and 12.5%, respectively (P = 0.653). Significantly shorter median postoperative hospital stay and median stay in the intensive care unit (ICU) were observed in group I (9 days [range, 5-39 days] vs. 12 days [range, 8-49 days], P = 0.015 and 0 day [range, 0-17 days] vs. 0.5 day [range, 0-18 days], P = 0.022, respectively). There were no differences in hospital mortality (P = 0.653) or 30-day mortality (P = 0.653). Both groups had similar reoperation rates, surgical complications, and medical complications. When compared with emergency resection, insertion of SEMS as a bridge to surgery for obstructing left-sided colorectal cancer is associated with a higher rate of primary anastomosis as well as a better outcome in terms of hospital stay and stay in the ICU. The wider application of this treatment option for obstructing colorectal cancer warranted further studies. |
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Authors:
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Ka Chun Ng; Wai Lun Law; Yee Man Lee; Hok Kwok Choi; Chi Leung Seto; Judy W C Ho |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract Volume: 10 ISSN: 1091-255X ISO Abbreviation: J. Gastrointest. Surg. Publication Date: 2006 Jun |
Date Detail:
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Created Date: 2006-06-13 Completed Date: 2006-11-14 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9706084 Medline TA: J Gastrointest Surg Country: United States |
Other Details:
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Languages: eng Pagination: 798-803 Citation Subset: IM |
Affiliation:
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Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Anastomosis, Surgical Case-Control Studies Colectomy* / methods Colorectal Neoplasms / complications, surgery*, therapy Emergency Treatment Female Humans Intestinal Obstruction / etiology, surgery* Length of Stay Male Middle Aged Retrospective Studies Stents* Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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