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DOI: 10.1055/s-0039-1681802
COMPLICATIONS IN THE MANAGEMENT OF ACUTE LEFT COLONIC NEOPLASTIC OBSTRUCTION WITH CURATIVE INTENTION. DO ENDOSCOPIC STENTS HAVE A PROTECTIVE EFFECT?
Publication History
Publication Date:
18 March 2019 (online)
Aims:
To evaluate factors involved in medical and surgical complications in patients with acute colonic obstruction secondary to left colon cancer treated with curative intention. We specifically compared the influence of stents.
Surgery |
Stent |
p |
OR |
|
Stoma |
17 (56,7%) |
16 (21,1%) |
0,001 |
0,20 (0,08 – 0,50) |
Surgical complications |
5 (16,7%) |
15 (19,7%) |
0,716 |
1,23 (0,40 – 3,74) |
Medical complications |
7 (23,3%) |
1 (1,3%) |
0,004 |
0,04 (0,00 – 0,37) |
Methods:
We performed an observational and retrospective study of patients attended in a single center for acute left colonic obstruction caused by cancer between 2007 and 2014. There were only included patients with curative intention, without metastasis at the time of diagnosis and treated with surgery with R0 resection.
Results:
There were included 106 patients. It was placed a colonic stent as a bridge in 76 (71,7%), and the rest were operated in an emergency setting. Surgical complication rate was lower in women, OR 0,30 (0,09 – 0,97). In multivariate analysis Charlson score, men and resection larger than 30 cm were associated with a higher surgical complication rate.
There were less medical complications in the postoperative period in patients with a colonic stent, OR 0,044 (0,00 – 0,37). In multivariate analysis, colonic stent and young age had fewer complications too.
The presence of stoma at discharge was less frequent in patients with a colonic stent, OR 0,20 (0,08 – 0,50), the ones with scheduled surgery, OR 0,09 (0,03 – 0,25), and higher in the ones who presented surgical complications, OR 2,73 (1,01 – 7,43). In multivariate analysis, the presence of colonic stent was associated with lower stoma rate.
Conclusions:
Colonic stents in patients with acute colonic obstruction secondary to left colon cancer treated with curative intent were associated in our study with a lower rate of medical complications and stoma but had no relationship with the presence of surgical complications.