THE SURGICAL MANAGEMENT OF LARGE BOWEL OBSTRUCTION IN PATIENTS WITH LEFT COLON AND RECTAL CANCER – A RETROSPECTIVE STUDY

  • M. DIACONESCU University of Medicine and Pharmacy of Craiova, Romania
  • A. NICOLAESCU University of Medicine and Pharmacy of Craiova, Romania
  • M. BICA University of Medicine and Pharmacy of Craiova, Romania
  • Georgiana GRAURE-COTOFANA University of Medicine and Pharmacy of Craiova
  • D.N. MARGARITESCU University of Medicine and Pharmacy of Craiova
  • Daniela MARINESCU University of Medicine and Pharmacy of Craiova
  • D. CARTU University of Medicine and Pharmacy of Craiova
  • A. PATRU Emergency County Hospital of Craiova, Romania
  • C. MIREA University of Medicine and Pharmacy of Craiova
  • S. PATRASCU University of Medicine and Pharmacy of Craiova
  • K. SAPALIDIS “Aristotle” University of Thessaloniki, Greece
  • V. SURLIN University of Medicine and Pharmacy of Craiova

Abstract

The optimal surgical attitude towards obstructed left colon and upper rectal cancer remains elusive, one of the main postoperative endpoints being to avoid the most dreaded complication of this type of procedures - the anastomotic leakage. Material and methods: We conducted a retrospective analysis of all patients with left colon and rectal cancer admitted and having emergency surgery performed in the surgical departments of the University County Hospital of Craiova, Romania, between 2001 and 2018. The timeline analysis showed an increasing interest for single-stage resection and anastomosis in the second decade (2011-2018) compared to the first decade of the study (28% vs. 11.2%). Results: The incidence of anastomotic leak for these types of procedures remained higher than for the two-stage procedure (15% vs. 4.8%), similar to the overall postoperative morbidity (30.3% vs. 20%) and mortality (3% vs. 1.1%). Postoperative morbidity and anastomotic leak rate were statistically higher in the single stage procedure group when compared with the two-stage procedure (p <0.05). Conclusions: Deciding between single-stage resection with anastomosis and a two-stage procedure requires a careful patient selection due to the relatively high risk of anastomotic leak in this specific category of patients.

Author Biographies

M. DIACONESCU, University of Medicine and Pharmacy of Craiova, Romania

6th Surgical Department

A. NICOLAESCU, University of Medicine and Pharmacy of Craiova, Romania

6th Surgical Department

M. BICA, University of Medicine and Pharmacy of Craiova, Romania

6th Surgical Department

Georgiana GRAURE-COTOFANA, University of Medicine and Pharmacy of Craiova

6th Surgical Department

D.N. MARGARITESCU, University of Medicine and Pharmacy of Craiova

6th Surgical Department

Daniela MARINESCU, University of Medicine and Pharmacy of Craiova

6th Surgical Department

D. CARTU, University of Medicine and Pharmacy of Craiova

6th Surgical Department

A. PATRU, Emergency County Hospital of Craiova, Romania

Department of Anesthesiology

C. MIREA, University of Medicine and Pharmacy of Craiova

6th Surgical Department

S. PATRASCU, University of Medicine and Pharmacy of Craiova

6th Surgical Department

K. SAPALIDIS, “Aristotle” University of Thessaloniki, Greece

3rd Surgical Department

V. SURLIN, University of Medicine and Pharmacy of Craiova

6th Surgical Department

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Published
2021-06-30