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Short- and long-term outcomes of subtotal/total colectomy in the management of obstructive left colon cancer

PURPOSE: Surgical management of obstructive left colon cancer (OLCC) is still a matter of debate. The classic Hartmann procedure (HP) has a disadvantage that requires a second major operation. Subtotal colectomy/total abdominal colectomy (STC/TC) with ileosigmoid or ileorectal anastomosis is propose...

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Autores principales: Son, Jung Tak, Kim, Yong Bog, Kim, Hyung Ook, Min, Chungki, Park, Yongjun, Lee, Sung Ryol, Jung, Kyung Uk, Kim, Hungdai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Coloproctology 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10338161/
https://www.ncbi.nlm.nih.gov/pubmed/35611549
http://dx.doi.org/10.3393/ac.2022.00101.0014
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author Son, Jung Tak
Kim, Yong Bog
Kim, Hyung Ook
Min, Chungki
Park, Yongjun
Lee, Sung Ryol
Jung, Kyung Uk
Kim, Hungdai
author_facet Son, Jung Tak
Kim, Yong Bog
Kim, Hyung Ook
Min, Chungki
Park, Yongjun
Lee, Sung Ryol
Jung, Kyung Uk
Kim, Hungdai
author_sort Son, Jung Tak
collection PubMed
description PURPOSE: Surgical management of obstructive left colon cancer (OLCC) is still a matter of debate. The classic Hartmann procedure (HP) has a disadvantage that requires a second major operation. Subtotal colectomy/total abdominal colectomy (STC/TC) with ileosigmoid or ileorectal anastomosis is proposed as an alternative procedure to avoid stoma and anastomotic leakage. However, doubts about morbidity and functional outcome and lack of long-term outcomes have made surgeons hesitate to perform this procedure. Therefore, this trial was designed to provide data for morbidity, functional outcomes, and long-term outcomes of STC/TC. METHODS: This study retrospectively analyzed consecutive cases of OLCC that were treated by STC/TC between January 2000 and November 2020 at a single tertiary referral center. Perioperative outcomes and long-term outcomes of STC/TC were analyzed. RESULTS: Twenty-five descending colon cancer (45.5%) and 30 sigmoid colon cancer cases (54.5%) were enrolled in this study. Postoperative complications occurred in 12 patients. The majority complication was postoperative ileus (10 of 12). Anastomotic leakage and perioperative mortality were not observed. At 6 to 12 weeks after the surgery, the median frequency of defecation was twice per day (interquartile range, 1–3 times per day). Eight patients (14.5%) required medication during this period, but only 3 of 8 patients required medication after 1 year. The 3-year disease-free survival was 72.7% and 3-year overall survival was 86.7%. CONCLUSION: The risk of anastomotic leakage is low after STC/TC. Functional and long-term outcomes are also acceptable. Therefore, STC/TC for OLCC is a safe, 1-stage procedure that does not require diverting stoma.
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spelling pubmed-103381612023-07-13 Short- and long-term outcomes of subtotal/total colectomy in the management of obstructive left colon cancer Son, Jung Tak Kim, Yong Bog Kim, Hyung Ook Min, Chungki Park, Yongjun Lee, Sung Ryol Jung, Kyung Uk Kim, Hungdai Ann Coloproctol Original Article PURPOSE: Surgical management of obstructive left colon cancer (OLCC) is still a matter of debate. The classic Hartmann procedure (HP) has a disadvantage that requires a second major operation. Subtotal colectomy/total abdominal colectomy (STC/TC) with ileosigmoid or ileorectal anastomosis is proposed as an alternative procedure to avoid stoma and anastomotic leakage. However, doubts about morbidity and functional outcome and lack of long-term outcomes have made surgeons hesitate to perform this procedure. Therefore, this trial was designed to provide data for morbidity, functional outcomes, and long-term outcomes of STC/TC. METHODS: This study retrospectively analyzed consecutive cases of OLCC that were treated by STC/TC between January 2000 and November 2020 at a single tertiary referral center. Perioperative outcomes and long-term outcomes of STC/TC were analyzed. RESULTS: Twenty-five descending colon cancer (45.5%) and 30 sigmoid colon cancer cases (54.5%) were enrolled in this study. Postoperative complications occurred in 12 patients. The majority complication was postoperative ileus (10 of 12). Anastomotic leakage and perioperative mortality were not observed. At 6 to 12 weeks after the surgery, the median frequency of defecation was twice per day (interquartile range, 1–3 times per day). Eight patients (14.5%) required medication during this period, but only 3 of 8 patients required medication after 1 year. The 3-year disease-free survival was 72.7% and 3-year overall survival was 86.7%. CONCLUSION: The risk of anastomotic leakage is low after STC/TC. Functional and long-term outcomes are also acceptable. Therefore, STC/TC for OLCC is a safe, 1-stage procedure that does not require diverting stoma. Korean Society of Coloproctology 2023-06 2022-05-25 /pmc/articles/PMC10338161/ /pubmed/35611549 http://dx.doi.org/10.3393/ac.2022.00101.0014 Text en Copyright © 2023 The Korean Society of Coloproctology https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Son, Jung Tak
Kim, Yong Bog
Kim, Hyung Ook
Min, Chungki
Park, Yongjun
Lee, Sung Ryol
Jung, Kyung Uk
Kim, Hungdai
Short- and long-term outcomes of subtotal/total colectomy in the management of obstructive left colon cancer
title Short- and long-term outcomes of subtotal/total colectomy in the management of obstructive left colon cancer
title_full Short- and long-term outcomes of subtotal/total colectomy in the management of obstructive left colon cancer
title_fullStr Short- and long-term outcomes of subtotal/total colectomy in the management of obstructive left colon cancer
title_full_unstemmed Short- and long-term outcomes of subtotal/total colectomy in the management of obstructive left colon cancer
title_short Short- and long-term outcomes of subtotal/total colectomy in the management of obstructive left colon cancer
title_sort short- and long-term outcomes of subtotal/total colectomy in the management of obstructive left colon cancer
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10338161/
https://www.ncbi.nlm.nih.gov/pubmed/35611549
http://dx.doi.org/10.3393/ac.2022.00101.0014
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