Early versus delayed resection in management of obstructing colorectal cancer.

Helmy, Abdelrhman Amro Hamdy; Mahran, Khaled Mohammed; El Sagheer, Emad Mohammed; Salah, Abdelrahman M.; Hendy, Mina Makram

doi:10.21608/mjmr.2024.311342.1778

Early versus delayed resection in management of obstructing colorectal cancer.

Articles in Press

Document Type : Original Article

Authors

¹ Department of General Surgery, Faculty of Medicine - Minia University

² Egypt, ElMinia university, faculty of medicine, professor of surgery .

³ General surgery department

⁴ General surgery, faculty of medicine, Minia university, egypt

⁵ General Surgery Department, faculty of medicine, minia University

10.21608/mjmr.2024.311342.1778

Abstract

Background: Most cases of colorectal carcinoma include obstruction on the left side of the digestive tract, and this cancer is becoming more common in young adults. Aim: The purpose of this study is to evaluate the pros and cons of early vs delayed resection for patients diagnosed with obstructive colorectal cancer in terms of potential for successful oncological resection, length of hospital stay, chance of survival, and other related patient morbidities such as wound complications, leakage, recurrence, and effects on adjuvant chemotherapy after surgery. Patients and methods: From January 2023 through November 2023, all patients admitted to Minia University Hospital with obstructive colon cancer were included in this prospective comparative analysis., group (A) including all patients underwent primary resection with or without diversion and group (B) including all patients underwent staged resection By diverting loop ileostomy followed by elective 2nd procedure of colon resection with or without stoma closure via open laparotomy or minimally invasive procedure (LAPAROSCOPY). Results: While both early and delayed resections offer comparable oncological outcomes and survival rates, the delayed approach is associated with longer hospital stay, better feasibility of complete oncological resection, less complications, low incidence of mortality, and better impacts on chemotherapy. Conclusion: Our results showed that postponing resection following diversion not only made the procedure less urgent, but also allowed for more careful dissection—crucial when dealing with colorectal cancer— In obstructive colorectal cancer, our small trial found that a delayed approach had better short-term outcomes than a one-stage resection.

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