Outcomes for patients with obstructing colorectal cancers treated with one-stage surgery using transanal drainage tubes

J Gastrointest Surg. 2014 Aug;18(8):1507-13. doi: 10.1007/s11605-014-2541-1. Epub 2014 May 29.

Abstract

Background: Acute colorectal obstruction requires immediate surgical treatment. Although one-stage surgery with transanal drainage tubes (TDT) is reportedly safe and feasible, the long-term outcome of this procedure remains unclear.

Aim: To assess the outcome of one-stage surgery using TDT in the acute left colon or rectal obstructions due to colorectal carcinomas.

Methods: Clinicopathological data were recorded from patients with colorectal cancer with acute obstructions between 2006 and 2013.

Results: A total of 43 patients were enrolled including 29 males and 14 females. Among 39 patients, TDT was successful in 33 (84 %) and was incomplete in 6. Thus, 33 patients received one-stage surgery with TDT decompression, and 9 patients, including 6 with incomplete decompression, received one-stage surgery with no decompression. No significant differences in clinicopathological factors were observed between decompression and non-decompression groups. Adjusted analyses revealed that decompression using TDT was significantly associated with OS (hazard ratio 0.24; 95 % confidence interval, 0.08-0.72; p = 0.01). Furthermore, OS in the TDT decompression group was significantly longer than that in the non-decompression group (p = 0.01).

Conclusions: One-stage surgery with decompression using TDT may be effective to avoid stomas and to improve overall survival in patients with obstructing colorectal cancers.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colectomy*
  • Colorectal Neoplasms / complications
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / surgery*
  • Decompression, Surgical / methods*
  • Drainage / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Intestinal Obstruction / etiology
  • Intestinal Obstruction / mortality
  • Intestinal Obstruction / surgery*
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome