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      Safety of subtotal or total colectomy with primary anastomosis compared to Hartmann procedure for left-sided colon cancer obstruction or perforation

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      https://www.riss.kr/link?id=A106510591

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      다국어 초록 (Multilingual Abstract)

      Purpose: Whether subtotal or total colectomy with primary anastomosis (PA) is safer than Hartmann procedure (HP) for left-sided colon cancer obstruction or perforation remains controversial. The purpose of this study was to compare postoperative morbidity, mortality, and defecation frequency between PA and HP for left-sided colon cancer obstruction or perforation. Methods: This retrospective study enrolled 54 patients from January 2014 to February 2018 who underwent emergency surgery due to left-sided colon cancer obstruction or perforation. Results: PA was carried out in 20 patients while HP was performed for 34 patients. Thirty-day mortality did not show significant difference between the two groups (15.0% vs. 14.7%, P=1.000). No anastomotic leakage occurred in PA group while three (8.8%) cases of stump leakage occurred in HP group. Stoma repair was performed for 13 cases (44.8%) and stoma reformation was performed for one case in HP group (7.7%). Stoma related complications occurred in five cases (17.24%). For patients after stoma repair, defecation frequency at 3 months after operation was 2.91±2.88 times per day in PA group and 2.86±2.63 times per day in HP group. At 1 year after operation, defecation frequency was changed to 1.40±1.12 times per day in PA group and 1.17±0.39 times per day in HP group. Conclusion: Primary ileosigmoid or ileorectal anastomosis for left-sided colon cancer obstruction or perforation is safe, and shows similar outcome of defecation frequency compared to H
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      Purpose: Whether subtotal or total colectomy with primary anastomosis (PA) is safer than Hartmann procedure (HP) for left-sided colon cancer obstruction or perforation remains controversial. The purpose of this study was to compare postoperative morbi...

      Purpose: Whether subtotal or total colectomy with primary anastomosis (PA) is safer than Hartmann procedure (HP) for left-sided colon cancer obstruction or perforation remains controversial. The purpose of this study was to compare postoperative morbidity, mortality, and defecation frequency between PA and HP for left-sided colon cancer obstruction or perforation. Methods: This retrospective study enrolled 54 patients from January 2014 to February 2018 who underwent emergency surgery due to left-sided colon cancer obstruction or perforation. Results: PA was carried out in 20 patients while HP was performed for 34 patients. Thirty-day mortality did not show significant difference between the two groups (15.0% vs. 14.7%, P=1.000). No anastomotic leakage occurred in PA group while three (8.8%) cases of stump leakage occurred in HP group. Stoma repair was performed for 13 cases (44.8%) and stoma reformation was performed for one case in HP group (7.7%). Stoma related complications occurred in five cases (17.24%). For patients after stoma repair, defecation frequency at 3 months after operation was 2.91±2.88 times per day in PA group and 2.86±2.63 times per day in HP group. At 1 year after operation, defecation frequency was changed to 1.40±1.12 times per day in PA group and 1.17±0.39 times per day in HP group. Conclusion: Primary ileosigmoid or ileorectal anastomosis for left-sided colon cancer obstruction or perforation is safe, and shows similar outcome of defecation frequency compared to H

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      참고문헌 (Reference)

      1 Pearce NW, "Timing and method of reversal of Hartmann’s procedure" 79 : 839-841, 1992

      2 Belmonte C, "The Hartmann procedure. First choice or last resort in diverticular disease?" 131 : 612-615, 1996

      3 Passman MA, "Synchronous colon primaries have the same prognosis as solitary colon cancers" 39 : 329-334, 1996

      4 Mitry E, "Surgery for colon and rectal cancer" 16 : 253-265, 2002

      5 Zorcolo L, "Safety of primary anastomosis in emergency colorectal surgery" 5 : 262-269, 2003

      6 Alcantara M, "Prospective, controlled, randomized study of intraoperative colonic lavage versus stent placement in obstructive left-sided colonic cancer" 35 : 1904-1910, 2011

      7 Salem L, "Primary anastomosis or Hartmann’s procedure for patients with diverticular peritonitis? A systematic review" 47 : 1953-1964, 2004

      8 Regenet N, "Primary anastomosis after intraoperative colonic lavage vs. Hartmann’s procedure in generalized peritonitis complicating diverticular disease of the colon" 18 : 503-507, 2003

      9 Mulder SA, "Prevalence and prognosis of synchronous colorectal cancer: a Dutch population-based study" 35 : 442-447, 2011

      10 Feingold D, "Practice parameters for the treatment of sigmoid diverticulitis" 57 : 284-294, 2014

      1 Pearce NW, "Timing and method of reversal of Hartmann’s procedure" 79 : 839-841, 1992

      2 Belmonte C, "The Hartmann procedure. First choice or last resort in diverticular disease?" 131 : 612-615, 1996

      3 Passman MA, "Synchronous colon primaries have the same prognosis as solitary colon cancers" 39 : 329-334, 1996

      4 Mitry E, "Surgery for colon and rectal cancer" 16 : 253-265, 2002

      5 Zorcolo L, "Safety of primary anastomosis in emergency colorectal surgery" 5 : 262-269, 2003

      6 Alcantara M, "Prospective, controlled, randomized study of intraoperative colonic lavage versus stent placement in obstructive left-sided colonic cancer" 35 : 1904-1910, 2011

      7 Salem L, "Primary anastomosis or Hartmann’s procedure for patients with diverticular peritonitis? A systematic review" 47 : 1953-1964, 2004

      8 Regenet N, "Primary anastomosis after intraoperative colonic lavage vs. Hartmann’s procedure in generalized peritonitis complicating diverticular disease of the colon" 18 : 503-507, 2003

      9 Mulder SA, "Prevalence and prognosis of synchronous colorectal cancer: a Dutch population-based study" 35 : 442-447, 2011

      10 Feingold D, "Practice parameters for the treatment of sigmoid diverticulitis" 57 : 284-294, 2014

      11 Sebastian S, "Pooled analysis of the efficacy and safety of self-expanding metal stenting in malignant colorectal obstruction" 99 : 2051-2057, 2004

      12 Constantinides VA, "Operative strategies for diverticular peritonitis: a decision analysis between primary resection and anastomosis versus Hartmann’s procedures" 245 : 94-103, 2007

      13 민청기, "Obstructive Left Colon Cancer Should Be Managed by Using a Subtotal Colectomy Instead of Colonic Stenting" 대한대장항문학회 32 (32): 215-220, 2016

      14 Tsuchiya A, "Mortality and morbidity after Hartmann’s procedure versus primary anastomosis without a diverting stoma for colorectal perforation: a nationwide observational study" 42 : 866-875, 2018

      15 Khosraviani K, "Hartmann procedure revisited" 166 : 878-881, 2000

      16 Ho KS, "Endoscopic stenting and elective surgery versus emergency surgery for left-sided malignant colonic obstruction: a prospective randomized trial" 27 : 355-362, 2012

      17 Hennekinne-Mucci S, "Emergency subtotal/total colectomy in the management of obstructed left colon carcinoma" 21 : 538-541, 2006

      18 McArdle CS, "Emergency presentation of colorectal cancer is associated with poor 5-year survival" 91 : 605-609, 2004

      19 Pirlet IA, "Emergency preoperative stenting versus surgery for acute left-sided malignant colonic obstruction: a multicenter randomized controlled trial" 25 : 1814-1821, 2011

      20 Oistamo E, "Emergency management with resection versus proximal stoma or stent treatment and planned resection in malignant left-sided colon obstruction" 14 : 232-, 2016

      21 Manceau G, "Elective subtotal colectomy with ileosigmoid anastomosis for colon cancer preserves bowel function and quality of life" 15 : 1078-1085, 2013

      22 Almadi MA, "Complications and survival in patients undergoing colonic stenting for malignant obstruction" 19 : 7138-7145, 2013

      23 Hoemke M, "Complicated diverticulitis of the sigmoid: a prospective study concerning primary resection with secure primary anastomosis" 16 : 420-424, 1999

      24 Park IJ, "Comparison of one-stage managements of obstructing left-sided colon and rectal cancer: stent-laparoscopic approach vs. intraoperative colonic lavage" 13 : 960-965, 2009

      25 Min-Ki Kim, "Comparative study between transanal tube and loop ileostomy in low anterior resection for mid rectal cancer: a retrospective single center trial" 대한외과학회 88 (88): 260-268, 2015

      26 Ghazal AH, "Colonic endolumenal stenting devices and elective surgery versus emergency subtotal/total colectomy in the management of malignant obstructed left colon carcinoma" 17 : 1123-1129, 2013

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