Large Bowel Obstruction - The Eastern Association for the Surgery of Trauma

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Eastern Association for the Surgery of Trauma

Large Bowel Obstruction

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Short-term outcomes of laparoscopic approach to colonic obstruction for colon cancer

Moghadamyeghaneh Z, Talus H, Ballantyne G, Stamos MJ, Pigazzi A.

Surg Endosc. 2021 Jun;35(6):2986-2996.

Rationale for Inclusion: NSQIP database review evaluating the morbidity of laparoscopic approach to obstructive colon cancer surgery

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Impact of hospital volume on outcomes after emergency management of obstructive colon cancer: a nationwide study of 1957 patients

Aubert M, Mege D, Manceau G, Bridoux V, Lakkis Z, Venara A, Voron T, Abdalla S, Beyer-Berjot L, Sielezneff I, Sabbagh C, Karoui M; AFC (French Surgical Association) Working Group.

Int J Colorectal Dis. 2020 Oct;35(10):1865-1874.

Rationale for Inclusion: Large, retrospective review of association between volume of patients treated with outcomes

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Comparison of decompressing stoma vs stent as a bridge to surgery for left-sided obstructive colon cancer

Veld JV, Amelung FJ, Borstlap WAA, van Halsema EE, Consten ECJ, Siersema PD, Ter Borg F, van der Zaag ES, de Wilt JHW, Fockens P, Bemelman WA, van Hooft JE, Tanis PJ; Dutch Snapshot Research Group.

JAMA Surg. 2020 Jan 8;155(3):206–15.

Rationale for Inclusion: Population-based cohort study comparing the use of stents to emergency surgery (decompressive stoma) for obstructive colon cancer

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Surgical management of obstructive right-sided colon cancer at a national level results of a multicenter study of the French Surgical Association in 776 patients

Mege D, Manceau G, Beyer-Berjot L, Bridoux V, Lakkis Z, Venara A, Voron T, Brunetti F, Sielezneff I, Karoui M; AFC (French Surgical Association) Working Group.

Eur J Surg Oncol. 2018 Oct;44(10):1522-1531.

Rationale for inclusion: This retrospective cohort study found that a majority of patients with obstructing right-sided colon cancer can be managed with resection and primary anastomosis but high-risk patients may benefit from a staged surgical approach.

CAVEAT: Retrospective national cohort study.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Colonic stenting as a bridge to surgery versus emergency surgery for malignant colonic obstruction: results of a multicentre randomised controlled trial (ESCO trial).

Arezzo A, Balague C, Targarona E, Borghi F, Giraudo G, Ghezzo L, Arroyo A, Sola-Vera J, De Paolis P, Bossotti M, Bannone E, Forcignanò E, Bonino MA, Passera R, Morino M.

Surg Endosc. 2017 Aug;31(8):3297-3305.

Rationale for inclusion: Multicenter study comparing self-expandable metallic stents as a bridge to surgery versus emergency surgery found no difference in morbidity and oncologic outcome at 36 months but there was a lower stoma rate in the stent group. A “non-inferiority” RCT with survival as primary end point would be the appropriate method to correctly investigate long-term outcomes after SEMS as BTS versus ES.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Colonic stenting versus emergency surgery for acute left-sided malignant colonic obstruction: a multicentre randomised trial.

van Hooft JE, Bemelman WA, Oldenburg B, Marinelli AW, Lutke Holzik MF, Grubben MJ, Sprangers MA, Dijkgraaf MG, Fockens P; collaborative Dutch Stent-In study group.

Lancet Oncol. 2011 Apr;12(4):344-52

Rationale for inclusion: One of the few multicenter randomized trials comparing stenting and emergency surgery for malignant large bowel obstruction. The authors concluded that colonic stenting has no decisive clinical advantages to emergency surgery but could be used as an alternative treatment in as yet undefined subsets of patients, although with caution because of concerns about tumor spread caused by perforation.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Endolaparoscopic approach vs conventional open surgery in the treatment of obstructing left-sided colon cancer: a randomized controlled trial.

Cheung HY, Chung CC, Tsang WW, Wong JC, Yau KK, Li MK.

Arch Surg. 2009 Dec;144(12):1127-32.

Rationale for inclusion: Despite being a smaller study, this RCT found that self-expanding metal stents are a safe and effective bridge to subsequent laparoscopic surgery in patients with obstructing left-sided colon cancer.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

An algorithm for the management of sigmoid colon volvulus and the safety of primary resection: experience with 827 cases.

Oren D, Atamanalp SS, Aydinli B, Yildirgan MI, Basoglu M, Polat KY, Onbas O.

Dis Colon Rectum. 2007 Apr;50(4):489-97.

Rationale for inclusion: This is one of the larger retrospective reviews pertaining to the management of sigmoid volvulus. The study advocates for the surgical management of this condition.

CAVEAT: Retrospective review.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.

Single-stage treatment for malignant left-sided colonic obstruction: a prospective randomized clinical trial comparing subtotal colectomy with segmental resection following intraoperative irrigation.

Evans RO, Thampi KA, Mukherjee K, Stephenson BM.

Br J Surg. 1996 Apr;83(4):572.

Rationale for inclusion: First prospective RCT to compare subtotal colectomy with segmental resection and anastomosis after intraoperative irrigation for malignant left sided colonic obstruction. The authors found no differences in terms of morbidity and mortality, but significantly worse functional results after TC.

Citations - To review the number of citations for this landmark paper, visit Google Scholar.