Annals of Coloproctology

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Original Article

Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer,Biomarker & risk factor

Surgical Risk and Pathological Results of Emergency Resection in the Treatment of Acutely Obstructing Colorectal Cancers: A Retrospective Cohort Study: Giovanni Domenico Tebala, Andrea Mingoli, Andrea Natili, Abdul Qayyum Khan, Gioia Brachini; Ann Coloproctol. 2021;37(1):21-28. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2019.03.10.1

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Purpose
The treatment of acutely obstructing colorectal cancers is still a matter of debate. The prevailing opinion is that an immediate resection should be performed whenever possible. This study sought to determine whether immediate resection is safe and oncologically valid.
Methods
We completed a retrospective 2-center cohort study using the medical records of patients admitted for acutely obstructing colorectal cancer under the care of the Colorectal Team, Noble’s Hospital, Isle of Man, and the Emergency Surgery Unit, Umberto I University Hospital, Rome, from March 2013 to May 2017. The primary endpoints were 90-day mortality and morbidity, reoperation rate, and length of stay. The secondary endpoints were status of margins, number of lymph nodes retrieved, and the rate of adequate nodal harvest.
Results
Sixty-three patients were retrospectively enrolled in the study. Mortality was associated with age > 80 years and Dukes B tumors. The length of hospital stay was shorter in patients who had their resection less than 24 hours from their admission, in those who had laparoscopic resection and in those with distal tumors. The number of lymph nodes retrieved and rate of R0 resections were similar to those reported in elective colorectal surgery and were greater in laparoscopic resections and in patients operated on within 24 hours, respectively.
Conclusion
Immediate resection is a safe and reliable option in patients with acutely obstructing colorectal cancer.

Citations

Citations to this article as recorded by

Complete Obstruction, a Real Risk Factor: A Comprehensive Study on Obstruction in Stage IIA Colon Cancer With Propensity Score Matching Analysis
Soo Young Oh, Chan Wook Kim, Seonok Kim, Min Hyun Kim, Young Il Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu
Clinical Colorectal Cancer.2024; 23(2): 135. CrossRef
Can clinicopathologic high-risk features in T3N0 colon cancer be reliable prognostic factors?
Hyun Gu Lee, Young IL Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu
Annals of Surgical Treatment and Research.2023; 104(2): 109. CrossRef
Fluorescence-guided colorectal surgery: applications, clinical results, and protocols
Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son
Annals of Surgical Treatment and Research.2023; 105(5): 252. CrossRef
Surgical safety in the COVID-19 era: present and future considerations
Young Il Kim, In Ja Park
Annals of Surgical Treatment and Research.2022; 102(6): 295. CrossRef
Failure to rescue after reoperation for major complications of elective and emergency colorectal surgery: A population-based multicenter cohort study
Marie T. Grönroos-Korhonen, Laura E. Koskenvuo, Panu J. Mentula, Selja K. Koskensalo, Ari K. Leppäniemi, Ville J. Sallinen
Surgery.2022; 172(4): 1076. CrossRef
Quality issues in emergency colorectal surgery
Tara Russell, Formosa Chen
Seminars in Colon and Rectal Surgery.2020; 31(4): 100784. CrossRef

Case Report

Major Pelvic Bleeding Following a Stapled Transanal Rectal Resection: Use of Laparoscopy as a Diagnostic Tool: Giovanni Domenico Tebala, Abdul Qayyum Khan, Sean Keane; Ann Coloproctol. 2016;32(5):195-198. Published online October 31, 2016; DOI: https://doi.org/10.3393/ac.2016.32.5.195

6,031 View
35 Download
3 Web of Science
5 Citations

Abstract PDF

Stapled transanal rectal resection (STARR) and stapled hemorrhoidopexy (SH) are well-established techniques for treating rectal prolapse and obstructed defecation syndrome (ODS). Occasionally, they can be associated with severe complications. We describe the case of a 59-year-old woman who underwent STARR for ODS and developed a postoperative pelvic hemorrhage. A computed tomography (CT) scan revealed a vast pelvic, retroperitoneal hematoma and free gas in the abdomen. Laparoscopy ruled out any bowel lesions, but identified a hematoma of the pelvis. Flexible sigmoidoscopy showed a small leakage of the rectal suture. The patient was treated conservatively and recovered completely. Surgeons performing STARR and SH must be aware of the risk of this rare, but severe, complication. If the patient is not progressing after a STARR or SH, a CT scan can be indicated to rule out intra-abdominal and pelvic hemorrhage. Laparoscopy is a diagnostic tool and should be associated with intraluminal exploration with flexible sigmoidoscopy.

Citations

Citations to this article as recorded by

Severe Postoperative Bleeding After Stapled Hemorrhoidopexy: Incidence and Causes
Huabing Chen, Zaili Tang, Zhousong Wu, Renjie Shi
Indian Journal of Surgery.2021; 83(5): 1223. CrossRef
Update on obstructed defecation syndrome
Reem A. Alharbi
Saudi Surgical Journal.2021; 9(1): 1. CrossRef
Perirectal Hematoma and Intra-Abdominal Bleeding after Stapled Hemorrhoidopexy and STARR—A Proposal for a Decision-Making Algorithm
Georgi Popivanov, Piergiorgio Fedeli, Roberto Cirocchi, Massimo Lancia, Domenico Mascagni, Michela Giustozzi, Ivan Teodosiev, Kirien Kjossev, Marina Konaktchieva
Medicina.2020; 56(6): 269. CrossRef
Common operation, uncommon complication. Bleeding from superior haemorrhoidal artery after minimally invasive procedure for hemorrhoids – a case report
Janavikula Sankaran Rajkumar, Aluru Jayakrishna Reddy, Ravikumar Radhakrishnan, Anirudh Rajkumar, Syed Akbar, Dharmendra Kollapalayam Raman
Journal of Coloproctology.2019; 39(01): 070. CrossRef
A Rare Complication of Stapled Hemorrhoidopexy: Giant Pelvic Hematoma Treated with Super-Selective Percutaneous Angioembolization
Francesco Ferrara, Paolo Rigamonti, Giovanni Damiani, Maurizio Cariati, Marco Stella
Annals of Colorectal Research.2018;[Epub] CrossRef

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