Outcomes for Patients with Obstructing Colorectal Cancers Treated with One-Stage Surgery Using Transanal Drainage Tubes

• Published in: Journal of gastrointestinal surgery 2014-08, Vol.18 (8), p.1507-1513
• Main Authors: Shigeta, Kohei, Baba, Hideo, Yamafuji, Kazuo, Kaneda, Hiroyuki, Katsura, Hideyuki, Kubochi, Kiyoshi
• Format: Article
• Language: English
• Subjects: Abdomen; Adult; Aged; Aged, 80 and over; Chemotherapy; Colectomy; Colonoscopy; Colorectal cancer; Colorectal Neoplasms - complications; Colorectal Neoplasms - mortality; Colorectal Neoplasms - surgery; Decompression, Surgical - methods; Drainage - methods; Female; Follow-Up Studies; Gastroenterology; Hospitals; Humans; Intestinal Obstruction - etiology; Intestinal Obstruction - mortality; Intestinal Obstruction - surgery; Kaplan-Meier Estimate; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Ostomy; Retrospective Studies; Surgery; Surgical anastomosis; Survival Rate; Treatment Outcome
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-014-2541-1

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.