Prospective, Randomized Trial Comparing Intraoperative Colonic Irrigation With Manual Decompression Only for Obstructed Left-Sided Colorectal Cancer

Lim, Jit-Fong; Tang, Choong Leong; Seow‐Choen, F.; Heah, S. M.

doi:10.1007/s10350-004-0803-9

Cited by 60 publications

(42 citation statements)

References 19 publications

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“…There is one RCT comparing ICI with manual decompression in acute left-sided colonic obstruction. 21 It concluded that manual decompression is as good as ICI with no difference in morbidity or mortality, and it is a shorter and simpler procedure. Other non-randomised studies or case series have shown manual decompression to be safe.…”

Section: Primary Resectionmentioning

confidence: 98%

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Emergency Management of Malignant Acute Left-Sided Colonic Obstruction

Trompetas

2008

annals

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The searches showed one Cochrane systematic review, two further systematic reviews, one meta-analysis, two decision METHODS A literature search was undertaken using PubMed and the Cochrane Library regarding the options in emergency management of left-sided colonic obstruction focusing on outcomes such as mortality, morbidity, long-term prognosis and cost effectiveness. DISCUSSION Colonic stenting is the best option either for palliation or as a bridge to surgery. It reduces morbidity and mortality rate and the need for colostomy formation. Stenting is likely to be cost effective, but data are variable depending on the individual healthcare system. Nevertheless, surgical management remains relevant as colonic stenting has a small rate of failure, and it is not always available. There are various surgical options. One-stage primary resection and anastomosis is the preferred choice for low-risk patients. Intra-operative colonic irrigation has no proven benefit. Subtotal colectomy is useful in cases of proximal bowel damage or synchronous tumours. Hartmann's procedure should be reserved for high-risk patients. Simple colostomy has no role other than for use in very ill patients who are not fit for any other procedure.

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Section: Primary Resectionmentioning

confidence: 98%

“…[18][19][20][21] This idea was supported by various RCTs comparing mechanical bowel preparation, with no preparation in elective open colonic surgery. The results were separately examined in a Cochrane systematic review of 9 RCTs 22 and in a metaanalysis of 7 RCTs.…”

Section: Primary Resectionmentioning

confidence: 99%

Emergency Management of Malignant Acute Left-Sided Colonic Obstruction

Trompetas

2008

annals

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“…(2005), в котором проводится сравнение сег-ментарной колэктомии с интраоперационной иррига-цией (n = 24) и сегментарной колэктомии с мануальной декомпрессией (n = 25) при обтурационной кишечной непроходимости опухолевого генеза. Авторы пришли к выводу, что мануальная декомпрессия является ме-нее продолжительной по времени и технически проще в исполнении, статистической разницы в послеопе-рационной летальности и частоте несостоятельности анастомоза не выявлено [58]. В 2009 г. M. H. Kam и соавт.…”

Section: Introductionunclassified

Surgical treatment of complicated colorectal cancer: tactical aspects (a literature review)

Щаева¹

2017

Onkol. koloproktol.

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“…Preoperative chemoradiotherapy (CRT) is strongly associated with poor anal function after ISR, and patients with rectal cancer who undergo ISR after preoperative CRT are likely to experience incontinence [11,12]. Lim et al [13] reported that a conventionally fractionated 45-Gy dose of preoperative CRT caused poor anorectal function due to damage to the pudendal nerve. Rectal function may also be worsened by radiation-induced proctitis and induction of rectal compliance due to fibrosis of the rectal wall [14,15].…”

Section: Introductionmentioning

confidence: 99%

Association between Anal Function and Therapeutic Effect after Preoperative Chemoradiotherapy followed by Intersphincteric Resection

Saitô¹,

Fujii²,

Ito³

et al. 2012

Dig Surg

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Background/Aims: Preoperative chemoradiotherapy (CRT) for rectal cancer improves local control, but can also induce severe anal dysfunction after surgery. The goal of the study was to assess the relationship of the therapeutic effect of CRT with anal function and prognosis after intersphincteric resection (ISR). Methods: The subjects were 37 patients with lower rectal cancer who underwent ISR with preoperative CRT. The rectal cancer regression grade (RCRG) was quantified based on histologic features of surgical specimens. The relationships of RCRG with anal function (assessed by questionnaire) and incontinence (Wexner score) were examined at 12 months after surgery. Results: The median Wexner scores at 12 months after stoma closure in RCRG1, -2, and -3 cases were 18.0, 7.5, and 4.5, respectively, and anal function differed significantly among these groups (p = 0.001). Four cases had local recurrence, but 5-year local recurrence rates did not differ significantly among the groups. The 5-year disease-free survival rates were 88.9, 50.8, and 50.0% and the 5-year overall survival rates were 100, 77.3, and 66.7% in RCRG1, -2, and -3 cases, respectively, with no significant differences among the groups. Conclusion: Postoperative anal function is decreased when the effect of preoperative CRT is strong in patients treated with ISR.

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Prospective, Randomized Trial Comparing Intraoperative Colonic Irrigation With Manual Decompression Only for Obstructed Left-Sided Colorectal Cancer

Abstract: Manual decompression of proximal colon without irrigation is as safe as colonic irrigation in one-stage surgical management of obstructing left-sided colorectal cancer.

Cited by 60 publications

References 19 publications

Emergency Management of Malignant Acute Left-Sided Colonic Obstruction

Emergency Management of Malignant Acute Left-Sided Colonic Obstruction

Surgical treatment of complicated colorectal cancer: tactical aspects (a literature review)

Association between Anal Function and Therapeutic Effect after Preoperative Chemoradiotherapy followed by Intersphincteric Resection

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