Long-Term Outcomes of the Obstruction Treatment in Benign and Malignant Colonic Obstruction: A Multicentre Study

Abstract

Introduction Patients with colonic obstruction are at risk for emergency resection, which is a risk factor for increased mortality and morbidity. In left-sided obstructive colon cancer, the principle of bridge-to-surgery is already recommended to reduce complications. From this treatment strategy, the obstruction treatment is derived. In this treatment strategy, bowel wall distention is reduced by minimizing stool production through laxatives and dietary measures. Short-term outcomes have already shown promising results. This study aims to evaluate long-term outcomes in patients treated with this obstruction treatment.

Methods This is a multicenter prospective study that included patients who presented with symptomatic colonic obstruction and radiologic confirmation of obstruction between May 2019 and August 2020 in the contributing hospitals. Patients with malignant and benign colonic obstruction were included. Follow-up in this study consisted of at least 36 months. Endpoints of the study included 1- and 3-year stoma and mortality rates.

Results Ninety-eight patients were included in this study. For the overall cohort complication, reoperation, and readmission rates after one year were 37%, 14%, and 10% respectively. Overall, 3-year mortality was 21%. The presence of a stoma after 1 year was 18%, and after 3 years 17% in this cohort.

Conclusion Long-term results of this study indicate that obstruction treatment has acceptable long-term outcomes in terms of mortality and stoma rates, compared to literature on emergency surgery and bridge-to-surgery alternatives. Permanent stoma rates are lower, compared to the literature on other treatment strategies in bowel obstruction.

Keywords

colorectal - bowel obstruction - obstructive - elective surgery

Authors' Contributions:

Smalbroek, Dijksman, Bloemen, Smits

Substantial contributions to the conception and design of the work: Smalbroek, Smits

Drafting the article: Smalbroek

Revising the article critically for important intellectual content: Dijksman, Bloemen, Smits

Final approval of the version to be published: Smalbroek, Dijksman, Bloemen, Smits

All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Data Availability Statement:

The data to support the findings of this study are available from the corresponding author upon reasonable request.

Publication History

Received: 22 January 2024

Accepted: 07 February 2024

Article published online:
06 June 2024

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