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Colonic Cancer in Occlusion: The Choice Between Synchronous and Sequential Surgery

Received: 2 November 2022     Accepted: 23 November 2022     Published: 9 January 2023
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Abstract

Introduction: Emergency tumor resection in monobloc is the most common. The alternative is to perform an emergency digestive bypass by a near upstream stoma if the patient's condition does not allow carcinological surgery. The objective of this study was to evaluate the results of single- versus multistage surgery in occluded colorectal cancer. Method: A single-center, cross-sectional study had included colonic cancers in occlusion operated on between 2015 and 2019 regardless of the evolutionary stage of the lesion. Patients operated in emergency for acute intestinal occlusion due to a colon tumor and whose histological result corresponded to a cancer were included. Results: The median age was 54.45 years (17 years; 78 years). The sex ratio was 0.93. The main surgical procedures were resection with immediate anastomosis in right hemicolectomies (n = 12) - left colectomy (n = 3), resection with two-stage anastomosis (segmental colectomy with colorectal anastomosis and/or colocolic anastomosis with protective ileostomy (n = 10), Hartmann procedure (n = 6)). The postoperative mortality rate was 3% (n = 1) of which one patient had an elective discharge colostomy. Mortality was more associated with the AFC score (age, urgency, nutritional and neurological status) than with the choice of surgery. Conclusion: One-stage surgery seems to show a slight superiority on the prognosis even in the context of occlusion. Diagnostic and therapeutic management still encounter difficulties in our context.

Published in European Journal of Clinical and Biomedical Sciences (Volume 8, Issue 6)
DOI 10.11648/j.ejcbs.20220806.11
Page(s) 80-83
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Bowel Obstruction, Cancer, Colectomy, Colostomy

References
[1] Santos AC, Martins LLT, Brasil AMS, Pinto AS, Neto SG, Oliveira EC. Emergency surgery for complicated colorectal cancer in central Brazil. J. Coloproctol 2014; 34 (2).
[2] Carraro PG, Segala M, Cesana BM, Tiberio G. Obstructing colonic cancer: failure and survival patterns over ten-year follow up after one stage curative surgery. Dis Colon Rectum 2001; 44: 240-50.
[3] Raveloson JR, Rantomalala HYH, Rakotoarisoa B, Rakotobe TB, Tovone GX, Gizy RD. Prise en charge des cancers du côlon en occlusion au Centre Hospitalier de Soavinandriana Madagascar. Méd Afr Noire. 2005; 5211: 633-7.
[4] Raoult A, Collet D, Sa Cunha A, Larronude D, Ndobo’epoy F, Masson B. Prise en charge du coancer colique en occlusion. Ann Chir. 2005; 130 (5): 331-5.
[5] Ramos R. Colon cancer surgery in patients operated on an emergency basis. REv Col Bras Cir. 2017; 44 (5): 465-70.
[6] Konaté I, Cissé M, Diallo OFK, Sridi A, Gaye M, Dieug M et al. Prise en charge des cancers colorectaux en occlusion à la Clinique chirurgicale Hôpital Aristide Le Dantec Dakar. Bull Med Owendo. 2009; 12 (34): 31-3.
[7] HAS. Principales indications et non-indications de la radiographie de l’abdomen sans préparation. 2009.
[8] Gainant A. Emergency management of acute colonic cancer obstruction. J Visc Surg. 2012; 149: e3-e10.
[9] Van Hooft JE, BemelmanWA, Oldenburg B, Marinelli AW, Holzik MF, Grubben MJ, et al. Colonic stenting vs emergency surgery for acute left-sided malignant colonic obstruction: a multicentric randomised trial. Lancet Oncol 2011; 12: 344-52.
[10] Frago R, Biondo S, Millan M, Kreisler E, Golda T, Fraccalvieri D, et al. Differences between proximal and distal obstructing colonic cancer after curative surgery. Colorectal Dis 3011; 13: 116-22.
[11] DodleyHa, Radcliffe AG, McGeehan D. Intraoperative irrigationof the colon topermitprimary anastomosis. Br J Surgery 1980; 67: 81-1.
[12] Lim JF, Tang CL, Seox-Choen F, Heah SM. Prospective randomised trial comparing intraoperative colonic irrigation with manual decompression only for obstructed left-sided colorectal cancer. Dis Colon Rectum. 2005; 48: 205-9.
[13] Breitenstein S, Richenbacher A, Berjads D, Puhan M, Clavien PA, Demartines N. Systematic evaluation of surgical strategies for acute malignant left-sided colonic obstruction. BR J Surg 2007; 94: 1451-60.
[14] Pa Ba, Wade TMM, Diop B, Faye M, Ngom A. Emergency management of colon cancer in occlusion at thies regional hospitzl in Senegal. J Afr Chir Digest 2017; 17 (2): 2223-27.
Cite This Article
  • APA Style

    Rasataharifetra Hanta, Rahantasoa Finaritra Casimir Fleur Prudence, Razafindraibe Vanona Barijaona, Mahavory Marc Joel, Samison Luc Herve, et al. (2023). Colonic Cancer in Occlusion: The Choice Between Synchronous and Sequential Surgery. European Journal of Clinical and Biomedical Sciences, 8(6), 80-83. https://doi.org/10.11648/j.ejcbs.20220806.11

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    ACS Style

    Rasataharifetra Hanta; Rahantasoa Finaritra Casimir Fleur Prudence; Razafindraibe Vanona Barijaona; Mahavory Marc Joel; Samison Luc Herve, et al. Colonic Cancer in Occlusion: The Choice Between Synchronous and Sequential Surgery. Eur. J. Clin. Biomed. Sci. 2023, 8(6), 80-83. doi: 10.11648/j.ejcbs.20220806.11

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    AMA Style

    Rasataharifetra Hanta, Rahantasoa Finaritra Casimir Fleur Prudence, Razafindraibe Vanona Barijaona, Mahavory Marc Joel, Samison Luc Herve, et al. Colonic Cancer in Occlusion: The Choice Between Synchronous and Sequential Surgery. Eur J Clin Biomed Sci. 2023;8(6):80-83. doi: 10.11648/j.ejcbs.20220806.11

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  • @article{10.11648/j.ejcbs.20220806.11,
      author = {Rasataharifetra Hanta and Rahantasoa Finaritra Casimir Fleur Prudence and Razafindraibe Vanona Barijaona and Mahavory Marc Joel and Samison Luc Herve and Rakotoarijaona Armand Herinirina},
      title = {Colonic Cancer in Occlusion: The Choice Between Synchronous and Sequential Surgery},
      journal = {European Journal of Clinical and Biomedical Sciences},
      volume = {8},
      number = {6},
      pages = {80-83},
      doi = {10.11648/j.ejcbs.20220806.11},
      url = {https://doi.org/10.11648/j.ejcbs.20220806.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ejcbs.20220806.11},
      abstract = {Introduction: Emergency tumor resection in monobloc is the most common. The alternative is to perform an emergency digestive bypass by a near upstream stoma if the patient's condition does not allow carcinological surgery.  The objective of this study was to evaluate the results of single- versus multistage surgery in occluded colorectal cancer. Method: A single-center, cross-sectional study had included colonic cancers in occlusion operated on between 2015 and 2019 regardless of the evolutionary stage of the lesion. Patients operated in emergency for acute intestinal occlusion due to a colon tumor and whose histological result corresponded to a cancer were included. Results: The median age was 54.45 years (17 years; 78 years). The sex ratio was 0.93. The main surgical procedures were resection with immediate anastomosis in right hemicolectomies (n = 12) - left colectomy (n = 3), resection with two-stage anastomosis (segmental colectomy with colorectal anastomosis and/or colocolic anastomosis with protective ileostomy (n = 10), Hartmann procedure (n = 6)). The postoperative mortality rate was 3% (n = 1) of which one patient had an elective discharge colostomy. Mortality was more associated with the AFC score (age, urgency, nutritional and neurological status) than with the choice of surgery. Conclusion: One-stage surgery seems to show a slight superiority on the prognosis even in the context of occlusion. Diagnostic and therapeutic management still encounter difficulties in our context.},
     year = {2023}
    }
    

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  • TY  - JOUR
    T1  - Colonic Cancer in Occlusion: The Choice Between Synchronous and Sequential Surgery
    AU  - Rasataharifetra Hanta
    AU  - Rahantasoa Finaritra Casimir Fleur Prudence
    AU  - Razafindraibe Vanona Barijaona
    AU  - Mahavory Marc Joel
    AU  - Samison Luc Herve
    AU  - Rakotoarijaona Armand Herinirina
    Y1  - 2023/01/09
    PY  - 2023
    N1  - https://doi.org/10.11648/j.ejcbs.20220806.11
    DO  - 10.11648/j.ejcbs.20220806.11
    T2  - European Journal of Clinical and Biomedical Sciences
    JF  - European Journal of Clinical and Biomedical Sciences
    JO  - European Journal of Clinical and Biomedical Sciences
    SP  - 80
    EP  - 83
    PB  - Science Publishing Group
    SN  - 2575-5005
    UR  - https://doi.org/10.11648/j.ejcbs.20220806.11
    AB  - Introduction: Emergency tumor resection in monobloc is the most common. The alternative is to perform an emergency digestive bypass by a near upstream stoma if the patient's condition does not allow carcinological surgery.  The objective of this study was to evaluate the results of single- versus multistage surgery in occluded colorectal cancer. Method: A single-center, cross-sectional study had included colonic cancers in occlusion operated on between 2015 and 2019 regardless of the evolutionary stage of the lesion. Patients operated in emergency for acute intestinal occlusion due to a colon tumor and whose histological result corresponded to a cancer were included. Results: The median age was 54.45 years (17 years; 78 years). The sex ratio was 0.93. The main surgical procedures were resection with immediate anastomosis in right hemicolectomies (n = 12) - left colectomy (n = 3), resection with two-stage anastomosis (segmental colectomy with colorectal anastomosis and/or colocolic anastomosis with protective ileostomy (n = 10), Hartmann procedure (n = 6)). The postoperative mortality rate was 3% (n = 1) of which one patient had an elective discharge colostomy. Mortality was more associated with the AFC score (age, urgency, nutritional and neurological status) than with the choice of surgery. Conclusion: One-stage surgery seems to show a slight superiority on the prognosis even in the context of occlusion. Diagnostic and therapeutic management still encounter difficulties in our context.
    VL  - 8
    IS  - 6
    ER  - 

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Author Information
  • Department of Visceral Surgery, Analankininina University Hospital, Toamasina, Madagascar

  • Department of Visceral Surgery, University Hospital Joseph Ravoahangy Andrianavalona, Antananarivo, Madagascar

  • Department of Visceral Surgery, Analankininina University Hospital, Toamasina, Madagascar

  • Department of Visceral Surgery, Analankininina University Hospital, Toamasina, Madagascar

  • Department of Visceral Surgery, University Hospital Joseph Ravoahangy Andrianavalona, Antananarivo, Madagascar

  • Department of Visceral Surgery, Analankininina University Hospital, Toamasina, Madagascar

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