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 proposed...
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| Format: | Article |
| Language: | English |
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Korean Society of Coloproctology
2023-06-01
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| Series: | Annals of Coloproctology |
| Subjects: | |
| Online Access: | http://coloproctol.org/upload/pdf/ac-2022-00101-0014.pdf |
| _version_ | 1797785464986402816 |
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| author | Jung Tak Son Yong Bog Kim Hyung Ook Kim Chungki Min Yongjun Park Sung Ryol Lee Kyung Uk Jung Hungdai Kim |
| author_facet | Jung Tak Son Yong Bog Kim Hyung Ook Kim Chungki Min Yongjun Park Sung Ryol Lee Kyung Uk Jung Hungdai Kim |
| author_sort | Jung Tak Son |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-13T00:54:25Z |
| format | Article |
| id | doaj.art-afdec15a498c4ad1bcb4ae4f38021bd4 |
| institution | Directory Open Access Journal |
| issn | 2287-9714 2287-9722 |
| language | English |
| last_indexed | 2024-03-13T00:54:25Z |
| publishDate | 2023-06-01 |
| publisher | Korean Society of Coloproctology |
| record_format | Article |
| series | Annals of Coloproctology |
| spelling | doaj.art-afdec15a498c4ad1bcb4ae4f38021bd42023-07-07T07:23:19ZengKorean Society of ColoproctologyAnnals of Coloproctology2287-97142287-97222023-06-0139326026610.3393/ac.2022.00101.00141934Short- and long-term outcomes of subtotal/total colectomy in the management of obstructive left colon cancerJung Tak Son0Yong Bog Kim1Hyung Ook Kim2Chungki Min3Yongjun Park4Sung Ryol Lee5Kyung Uk Jung6Hungdai Kim7 Department of Surgery, H Plus Yangji Hospital, Seoul, Korea Department of Medicine, Graduate School, Kyung Hee University, Seoul, Korea Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, KoreaPurpose 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.http://coloproctol.org/upload/pdf/ac-2022-00101-0014.pdfcolectomyobstructive left colon cancertreatment outcome |
| spellingShingle | Jung Tak Son Yong Bog Kim Hyung Ook Kim Chungki Min Yongjun Park Sung Ryol Lee Kyung Uk Jung Hungdai Kim Short- and long-term outcomes of subtotal/total colectomy in the management of obstructive left colon cancer Annals of Coloproctology colectomy obstructive left colon cancer treatment outcome |
| 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 | colectomy obstructive left colon cancer treatment outcome |
| url | http://coloproctol.org/upload/pdf/ac-2022-00101-0014.pdf |
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