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International Journal of Colorectal Disease

, Volume 34, Issue 11, pp 1933–1943 | Cite as

Long-term outcome after one-stage surgery without preoperative decompression for stage II/III malignant colorectal obstruction: a propensity score-matched analysis

  • Hiroshi TakeyamaEmail author
  • Kimimasa Ikeda
  • Katsuki Danno
  • Takahiko Nishigaki
  • Masafumi Yamashita
  • Hirokazu Taniguchi
  • Yoshio Oka
Original Article
  • 16 Downloads

Abstract

Purpose

Whether malignant colorectal obstruction (MCO) after one-stage curative surgery without preoperative decompression has a poor prognosis remains unclear. We assessed long-term outcomes of one-stage surgery without preoperative decompression for stage II/III MCO.

Methods

We retrospectively enrolled patients with stage II/III colorectal cancer (CRC) between April 2011 and December 2017. Propensity score-matched (PSM) analysis was used to reduce the possibility of selection bias.

Results

In total, 464 stage II/III CRC patients were identified, of which 145 (31%) had obstruction (MCO group) and 319 (69%) did not (non-MCO group). In the MCO group, 59 (40.7%) had emergency MCO (E-MCO) and 86 (59.3%) had semi-emergency MCO (SE-MCO). The median follow-up was 37.0 (range 0–86.5) months. The tumor was deeper and larger, and serum carcinoembryonic antigen level was higher (p < 0.001, respectively) in the MCO group (including E-MCO and SE-MCO). Venous invasion-positivity rate was significantly higher (MCO and SE-MCO only, p = 0.003 and 0.009, respectively) than that in the non-MCO group. Laparoscopic surgery rate was significantly lower (MCO and E-MCO only, p < 0.001) than that in the non-MCO group. Before PSM, disease-free survival (DFS) of the SE-MCO patients was worse than that of the non-MCO patients (p = 0.046). After PSM, DFS was not significantly different between the non-MCO and MCO, E-MCO, and SE-MCO groups (p = 0.619, 0.091, and 0.308, respectively).

Conclusions

Long-term prognosis in patients with stage II/III MCO after one-stage surgery without preoperative decompression was similar to that in patients without MCO.

Keywords

One-stage surgery Malignant colorectal obstruction Colorectal cancer Preoperative decompression Emergency 

Notes

Compliance with ethical standards

The study protocol was approved by the Institutional Review Board of Minoh City Hospital (IRB No. R01-B4) and was conducted according to the ethical guidelines of the Declaration of Helsinki.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Gastroenterological SurgeryMinoh City HospitalOsakaJapan

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