Short- and long-term outcomes following bridge to surgery and emergency resection in acute malignant large bowel obstruction
(2023) In Colorectal Disease 25(4). p.669-678- Abstract
Aim: Bridge to surgery (BtS) aims to decrease perioperative morbidity and mortality in emergency resection (ER) of the colon. Previous results are inconsistent, and long-term comparisons are scarce. The aim of this study was to compare the short- and long-term outcomes of BtS and ER. Method: This retrospective study examined data from the Swedish Colorectal Cancer Registry for patients treated for acute malignant large bowel obstruction from 2007 to 2009. Patients were grouped by treatment strategy: BtS (using a self-expanding metallic stent or diverting stoma) or ER. Medical records were scrutinized for all patients in the BtS group. The primary endpoints were 5-year overall survival (OS) and 3-year recurrence-free survival (RFS). The... (More)
Aim: Bridge to surgery (BtS) aims to decrease perioperative morbidity and mortality in emergency resection (ER) of the colon. Previous results are inconsistent, and long-term comparisons are scarce. The aim of this study was to compare the short- and long-term outcomes of BtS and ER. Method: This retrospective study examined data from the Swedish Colorectal Cancer Registry for patients treated for acute malignant large bowel obstruction from 2007 to 2009. Patients were grouped by treatment strategy: BtS (using a self-expanding metallic stent or diverting stoma) or ER. Medical records were scrutinized for all patients in the BtS group. The primary endpoints were 5-year overall survival (OS) and 3-year recurrence-free survival (RFS). The secondary endpoints were postoperative mortality and morbidity rates and stoma permanence. Results: Overall, 143 patients were treated using BtS versus 1302 patients treated with ER. The 5-year OS was higher in the BtS group than in the ER group (53.8% vs. 37.4%; p < 0.05). No difference was noted in the 3-year RFS (75.7% vs. 75.0%; p = 0.38). The postoperative mortality rate was lower in the BtS group than in the ER group (0.7% vs. 7.3%; p < 0.05). Complications occurred in 46.9% of patients in the BtS group (both procedures) versus 35.9% of patients in the ER group (p < 0.05); the rate of severe complications was 23.1% and 16.9%, respectively (p = 0.07). Conclusion: This retrospective population-based registry study showed higher long-term survival and lower postoperative mortality rates among patients treated with BtS versus ER for acute malignant large bowel obstruction.
(Less)
- author
- Arnarson, Örvar LU ; Axmarker, Tobias LU and Syk, Ingvar LU
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- bridge to surgery, BTS, emergency colon cancer surgery, obstructive colon cancer, SEMS
- in
- Colorectal Disease
- volume
- 25
- issue
- 4
- pages
- 669 - 678
- publisher
- Wiley-Blackwell
- external identifiers
-
- scopus:85146163044
- pmid:36567604
- ISSN
- 1462-8910
- DOI
- 10.1111/codi.16458
- language
- English
- LU publication?
- yes
- id
- 66759d2f-de1f-48d0-a1e4-3826738a991f
- date added to LUP
- 2023-02-16 09:47:27
- date last changed
- 2024-04-28 05:58:24
@article{66759d2f-de1f-48d0-a1e4-3826738a991f,
abstract = {{<p>Aim: Bridge to surgery (BtS) aims to decrease perioperative morbidity and mortality in emergency resection (ER) of the colon. Previous results are inconsistent, and long-term comparisons are scarce. The aim of this study was to compare the short- and long-term outcomes of BtS and ER. Method: This retrospective study examined data from the Swedish Colorectal Cancer Registry for patients treated for acute malignant large bowel obstruction from 2007 to 2009. Patients were grouped by treatment strategy: BtS (using a self-expanding metallic stent or diverting stoma) or ER. Medical records were scrutinized for all patients in the BtS group. The primary endpoints were 5-year overall survival (OS) and 3-year recurrence-free survival (RFS). The secondary endpoints were postoperative mortality and morbidity rates and stoma permanence. Results: Overall, 143 patients were treated using BtS versus 1302 patients treated with ER. The 5-year OS was higher in the BtS group than in the ER group (53.8% vs. 37.4%; p < 0.05). No difference was noted in the 3-year RFS (75.7% vs. 75.0%; p = 0.38). The postoperative mortality rate was lower in the BtS group than in the ER group (0.7% vs. 7.3%; p < 0.05). Complications occurred in 46.9% of patients in the BtS group (both procedures) versus 35.9% of patients in the ER group (p < 0.05); the rate of severe complications was 23.1% and 16.9%, respectively (p = 0.07). Conclusion: This retrospective population-based registry study showed higher long-term survival and lower postoperative mortality rates among patients treated with BtS versus ER for acute malignant large bowel obstruction.</p>}},
author = {{Arnarson, Örvar and Axmarker, Tobias and Syk, Ingvar}},
issn = {{1462-8910}},
keywords = {{bridge to surgery; BTS; emergency colon cancer surgery; obstructive colon cancer; SEMS}},
language = {{eng}},
number = {{4}},
pages = {{669--678}},
publisher = {{Wiley-Blackwell}},
series = {{Colorectal Disease}},
title = {{Short- and long-term outcomes following bridge to surgery and emergency resection in acute malignant large bowel obstruction}},
url = {{http://dx.doi.org/10.1111/codi.16458}},
doi = {{10.1111/codi.16458}},
volume = {{25}},
year = {{2023}},
}