Endoscopy 2019; 51(04): S212
DOI: 10.1055/s-0039-1681802
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Colon and rectum ePosters
Georg Thieme Verlag KG Stuttgart · New York

COMPLICATIONS IN THE MANAGEMENT OF ACUTE LEFT COLONIC NEOPLASTIC OBSTRUCTION WITH CURATIVE INTENTION. DO ENDOSCOPIC STENTS HAVE A PROTECTIVE EFFECT?

I Couto-Worner
1   Gastroenterology, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain
,
A Guerrero-Montañés
1   Gastroenterology, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain
,
M López-Álvarez
1   Gastroenterology, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain
,
L Yáñez-González-Dopeso
1   Gastroenterology, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain
,
M Teresa Seoane-Pillado
2   Statistics, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain
,
P Alonso-Aguirre
1   Gastroenterology, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

To evaluate factors involved in medical and surgical complications in patients with acute colonic obstruction secondary to left colon cancer treated with curative intention. We specifically compared the influence of stents.

Tab. 1:

Univariate analysis of complications in patients with neoplastic acute left colonic obstruction treated with curative intention

Surgery

Stent

p

OR

Stoma

17 (56,7%)

16 (21,1%)

0,001

0,20 (0,08 – 0,50)

Surgical complications

5 (16,7%)

15 (19,7%)

0,716

1,23 (0,40 – 3,74)

Medical complications

7 (23,3%)

1 (1,3%)

0,004

0,04 (0,00 – 0,37)

Methods:

We performed an observational and retrospective study of patients attended in a single center for acute left colonic obstruction caused by cancer between 2007 and 2014. There were only included patients with curative intention, without metastasis at the time of diagnosis and treated with surgery with R0 resection.

Results:

There were included 106 patients. It was placed a colonic stent as a bridge in 76 (71,7%), and the rest were operated in an emergency setting. Surgical complication rate was lower in women, OR 0,30 (0,09 – 0,97). In multivariate analysis Charlson score, men and resection larger than 30 cm were associated with a higher surgical complication rate.

There were less medical complications in the postoperative period in patients with a colonic stent, OR 0,044 (0,00 – 0,37). In multivariate analysis, colonic stent and young age had fewer complications too.

The presence of stoma at discharge was less frequent in patients with a colonic stent, OR 0,20 (0,08 – 0,50), the ones with scheduled surgery, OR 0,09 (0,03 – 0,25), and higher in the ones who presented surgical complications, OR 2,73 (1,01 – 7,43). In multivariate analysis, the presence of colonic stent was associated with lower stoma rate.

Conclusions:

Colonic stents in patients with acute colonic obstruction secondary to left colon cancer treated with curative intent were associated in our study with a lower rate of medical complications and stoma but had no relationship with the presence of surgical complications.