Primary vs. delayed resection for obstructive left-sided colorectal cancer: Impact of surgery on patient outcome

J. K. Jiang*, Y. T. Lan, T. C. Lin, W. S. Chen, S. H. Yang, H. S. Wang, S. C. Chang, J. K. Lin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

Abstract

PURPOSE: By comparing surgical outcomes between primary and delayed resection, we addressed whether and how surgical strategies impacted prognosis of patients with left-sided colorectal cancer underwent emergency curative resection. METHODS: Between January 1980 and December 2002, a total of 143 patients were identified who presented with obstructive left-sided colorectal cancer and received emergency curative resection in Taipei Veterans General Hospital. Patients were stratified according to the timing of tumor resection into two groups: primary resection and delayed resection. Demographic data of the patients, characteristics of the tumors, and short-term and long-term outcomes were analyzed and compared between the two groups. RESULTS: The demographic data and tumor characteristics did not differ between the two groups except for more rectal cancers in the delayed resection group (P=0.021). Primary resection group had a higher anastomotic leakage rate (P=0.017) and a trend toward a higher mortality rate, which did not reach statistical significance (P=0.063). The median follow-up intervals were similar (60.4 vs. 58.3 months; P=0.79). The median survival tended to be longer in delayed resection group (66 vs. 105 months; P=0.088). Overall five-year and ten-year survival for primary resection were 43.7 and 31.9 percent, respectively, compared with 67.2 and 53.2 percent, respectively, for delayed resection. CONCLUSIONS: Delayed resection seems to be a safer procedure and provided a better oncologic outcome compared with primary resection in obstructive left-sided colorectal cancer under emergency situations.

Original languageEnglish
Pages (from-to)306-311
Number of pages6
JournalDiseases of the Colon and Rectum
Volume51
Issue number3
DOIs
StatePublished - Mar 2008

Keywords

  • Delayed resection
  • Left-sided colorectal cancer
  • Obstruction
  • Primary resection

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