Laparoscopic resection followed by decompression with a drainage tube for obstructive colorectal cancer.

Authors

null

Yoshinori Kagawa

Kansai Rosai Hospital, Amagasaki, Japan

Yoshinori Kagawa , Kohei Murata , Atsushi Naito , Kenji Kawai , Yutaka Takeda , Atsushi Takeno , Toru Masuzawa , Yoshiaki Ohmura , Yoshiteru Katsura , Kohei Murakami , Takuya Sakamoto , Ryota Mori , Yohei Nose , Keisuke Toya , Yoshiro Yukawa , Kouki Takase , Takeshi Kato

Organizations

Kansai Rosai Hospital, Amagasaki, Japan, Kanasai Rosai Hospital, Amagasaki, Japan, Kansai Rosai Hospital, Hyogo, Japan, Department of Surgery, Amagasaki, Japan

Research Funding

Other

Background: Obstructive colorectal cancer is an oncological emergency that requires emergency treatment. In Japan, laparoscopic resection after decompression with metallic-stent placement is becoming mainstream as a bridge to surgery (BTS). However, there are reports of worse prognoses due to stent placement, and the European Gastroenterology Society of Endoscopy guidelines do not recommend BTS. In our department, since 2011 the first choice of the treatment has been laparoscopic resection after decompression with a trans-anal or trans-nasal drainage tube. STo investigate the safety and short- and long-term results of laparoscopic resection after decompression with a drainage tube. Methods: Eighty-one cases of obstructive colorectal cancer that underwent surgery at our hospital from 2011 to 2016 were investigated with regards to the short- and long-term outcomes of treatment strategies for obstructive colorectal cancer. Results: The median age was 72 years old (39-94). The ratio of male to female was 46:29. The success rate of decompression was 86.7% (66 cases). Stages II, III and IV were involved in 25, 28 and 28 cases, respectively. The causes of the emergency operations were an inability to insert both the ileus tube and the stent (9.3%, 7 cases), and perforation (2.7%, 2 cases) when the trans-anal ileus tube was inserted. In the cases in which decompression was possible, the laparoscopic operation rate was 89.4% (56 cases) and the primary resection rate was 90.9% (59 cases). The median surgical time was 194 minutes (27-325), the median blood loss was 10 g (0-660 g),The median postoperative hospital stay was 14 days (5-147 days). The rate of anastomotic leak was 4.5%. There were no deaths within 30 and 90 days after surgery. The relapse free survival rate in Stage II and III were 72% and 67.9%, respectively. The median months of overall survival in Stage II, III and IV were 60.4, 56.3 and 18.7, respectively. Conclusions: A treatment strategy with laparoscopic resection followed by decompression with a drainage tube was performed feasibly and safely. At this time, the effects of a stent on oncological prognosis is unclear, and this strategy could be an effective treatment for obstructive colorectal cancer.

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Abstract Details

Meeting

2018 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session C: Cancers of the Colon, Rectum, and Anus

Track

Cancers of the Colon, Rectum, and Anus

Sub Track

Multidisciplinary Treatment

Citation

J Clin Oncol 36, 2018 (suppl 4S; abstr 844)

DOI

10.1200/JCO.2018.36.4_suppl.844

Abstract #

844

Poster Bd #

N20

Abstract Disclosures

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