Influence of surgical treatment on early postoperative anal function in left colon cancer patients with acute complete obstruction_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 HUANG Rongsen , ZHU Ming , PAN Junjiang

Department of General Surgery, South District, Yibin Second People’s Hospital, Yibin, Sichuan 644000, P. R. China;

Corresponding author：

HUANG Rongsen, Email: huangrongsen1982@163.com

Keywords：

left colon cancer; complete obstruction; surgery; anal function; quality of life

DOI：

10.7507/1007-9424.202205032

Video：

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Objective To investigate the influence of surgical treatment on early postoperative anal function in left colon cancer patients with acute complete obstruction. Methods The clinical data of left colon cancer patients with acute complete obstruction were retrospectively chosen from January 2017 to June 2020 in Yibin Second People’s Hospital. The patients were grouped according to the treatment plan including emergency operation group (54 cases), stent+operation group (46 cases) and stent+neoadjuvant chemotherapy (NAC)+operation group (44 cases). The anal function was evaluated at 4 weeks, 1 month and 6 months after operation, and quality of life was evaluated at 12 months after operation. Unconditional logistic regression model was used to explore the factors influencing early postoperative anal function injury. Results The proportion of open surgery in the emergency operation group was statistically higher than the stent+operation group and stent+NAC+operation group (P<0.05). The low anterior rectum resection syndrome (LARS) score at 4 weeks after operation of the emergency operation group was statistically higher than those of the stent+operation group and stent+NAC+operation group (P<0.05). However there was no statistical difference in LARS score at 1 month and 6 months after operation among the three groups (P>0.05). The score of social function in the emergency operation group at 12 months after operation was statistically lower than those of the stent+operation group and stent+NAC+operation group (P<0.05). Multivariate logistic regression analysis showed that body mass index (BMI) ≥24 kg/m², emergency operation, and Eastern Collaborative Oncology Group (ECOG) score were the risk factors for early postoperative anal dysfunction in the left colon cancer patients with acute complete obstruction (P<0.05). Conclusions Left colon cancer patients complicated with acute complete obstruction who only received emergency surgery, BMI≥24 kg/m², or one score of ECOG are more likely to have functional impairment, and the quality of life of those patients underwent emergency surgery alone is decreased. In addition, the stent placement at the obstruction site should be helpful to avoid the above problems.

Citation： HUANG Rongsen, ZHU Ming, PAN Junjiang. Influence of surgical treatment on early postoperative anal function in left colon cancer patients with acute complete obstruction. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(4): 460-466. doi: 10.7507/1007-9424.202205032 Copy

1.	王礽, 陈治民, 纪振鑫, 等. 急诊手术和自膨式金属支架肠道置入治疗左半结肠癌伴梗阻的对照研究. 中国普外基础与临床杂志, 2021, 28(11): 1450-1456.
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11.	Seow-En I, Chok AY, Matchar DB, et al. Long-term quality of life, sexual health and gastrointestinal function following colorectal cancer resection in an Asian cohort. Colorectal Dis, 2021, 23(9): 2348-2360.
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14.	高加勒, 安勇博, 汪栋, 等. 直肠癌保肛术后短期生活质量研究现状. 中华胃肠外科杂志, 2020, 23(4): 415-420.
15.	Burbridge B, Lim H, Dwernychuk L, et al. Comparison of the quality of life of patients with breast or colon cancer with an arm vein port (TIVAD) versus a peripherally inserted central catheter (PICC). Curr Oncol, 2021, 28(2): 1495-1506.
16.	Amelung FJ, Burghgraef TA, Tanis PJ, et al. Critical appraisal of oncological safety of stent as bridge to surgery in left-sided obstructing colon cancer; a systematic review and meta-analysis. Crit Rev Oncol Hematol, 2018, 131(8): 66-75.
17.	Tang X, Zhang M, Wang C, et al. Preservation of the left colic artery and superior rectal artery in laparoscopic surgery can reduce anastomotic leakage in sigmoid colon cancer. J Minim Access Surg, 2021, 17(2): 208-212.
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21.	Han JG, Wang ZJ, Dai Y, et al. Short-term outcomes of elective surgery following self-expandable metallic stent and neoadjuvant chemotherapy in patients with left-sided colon cancer obstruction. Dis Colon Rectum, 2022 May 30. Online ahead of print. doi: 10.1097/DCR.0000000000002372.
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23.	Sugiura K, Seo Y, Aoki H, et al. Bridge to surgery for obstructing colonic cancer: a comparison between right- and left-sided lesions. J Anus Rectum Colon, 2021, 5(1): 34-39.

1. 王礽, 陈治民, 纪振鑫, 等. 急诊手术和自膨式金属支架肠道置入治疗左半结肠癌伴梗阻的对照研究. 中国普外基础与临床杂志, 2021, 28(11): 1450-1456.
2. Vos JAM, Duineveld LAM, Wieldraaijer T, et al. Effect of general practitioner-led versus surgeon-led colon cancer survivorship care, with or without eHealth support, on quality of life (I CARE): an interim analysis of 1-year results of a randomised, controlled trial. Lancet Oncol, 2021, 22(8): 1175-1187.
3. Cheng CY, Datzmann T, Hernandez D, et al. Do certified cancer centers provide more cost-effective care? A health economic analysis of colon cancer care in Germany using administrative data. Int J Cancer, 2021, 149(10): 1744-1754.
4. Benson AB, Venook AP, Al-Hawary MM, et al. NCCN guidelines insights: rectal cancer, version 6. 2020. J Natl Compr Canc Netw, 2020, 18(7): 806-815.
5. Franssen RFW, Strous MTA, Bongers BC, et al. The association between treatment interval and survival in patients with colon or rectal cancer: a systematic review. World J Surg, 2021, 45(9): 2924-2937.
6. Han JG, Wang ZJ, Zeng WG, et al. Efficacy and safety of self-expanding metallic stent placement followed by neoadjuvant chemotherapy and scheduled surgery for treatment of obstructing left-sided colonic cancer. BMC Cancer, 2020, 20(1): 57-64.
7. Wu J, Wei C, Li F, et al. The effect of comprehensive nursing on the recovery speed and prognosis of elderly colon cancer patients. Am J Transl Res, 2021, 13(5): 5491-5497.
8. Pieniowski EHA, Palmer GJ, Juul T, et al. Low anterior resection syndrome and quality of life after sphincter-sparing rectal cancer surgery: a long-term longitudinal follow-up. Dis Colon Rectum, 2019, 62(1): 14-20.
9. Niemeläinen S, Huhtala H, Ehrlich A, et al. Surgical and functional outcomes and survival following colon cancer surgery in the aged: a study protocol for a prospective, observational multicentre study. BMC Cancer, 2021, 21(1): 698-704.
10. Veld JV, Amelung FJ, Borstlap WAA, et al. Comparison of decompressing stoma vs stent as a bridge to surgery for left-sided obstructive colon cancer. JAMA Surg, 2020, 155(3): 206-215.
11. Seow-En I, Chok AY, Matchar DB, et al. Long-term quality of life, sexual health and gastrointestinal function following colorectal cancer resection in an Asian cohort. Colorectal Dis, 2021, 23(9): 2348-2360.
12. Croese AD, Lonie JM, Trollope AF, et al. A meta-analysis of the prevalence of low anterior resection syndrome and systematic review of risk factors. Int J Surg, 2018, 56: 234-241.
13. Thong MSY, Jansen L, Chang-Claude J, et al. Correction to: association of laparoscopic colectomy versus open colectomy on the long-term health-related quality of life of colon cancer survivors. Surg Endosc, 2021, 35(8): 4900-4910.
14. 高加勒, 安勇博, 汪栋, 等. 直肠癌保肛术后短期生活质量研究现状. 中华胃肠外科杂志, 2020, 23(4): 415-420.
15. Burbridge B, Lim H, Dwernychuk L, et al. Comparison of the quality of life of patients with breast or colon cancer with an arm vein port (TIVAD) versus a peripherally inserted central catheter (PICC). Curr Oncol, 2021, 28(2): 1495-1506.
16. Amelung FJ, Burghgraef TA, Tanis PJ, et al. Critical appraisal of oncological safety of stent as bridge to surgery in left-sided obstructing colon cancer; a systematic review and meta-analysis. Crit Rev Oncol Hematol, 2018, 131(8): 66-75.
17. Tang X, Zhang M, Wang C, et al. Preservation of the left colic artery and superior rectal artery in laparoscopic surgery can reduce anastomotic leakage in sigmoid colon cancer. J Minim Access Surg, 2021, 17(2): 208-212.
18. Skelton WP, Franke AJ, Iqbal A, et al. Comprehensive literature review of randomized clinical trials examining novel treatment advances in patients with colon cancer. J Gastrointest Oncol, 2020, 11(4): 790-802.
19. Katsuki R, Jo T, Yasunaga H, et al. Outcomes of self-expandable metal stent as bridge to surgery versus emergency surgery for left-sided obstructing colon cancer: a retrospective cohort study. Am J Surg, 2021, 221(1): 168-173.
20. Lauro A, Binetti M, Vaccari S, et al. Obstructing left-sided colonic cancer: is endoscopic stenting a bridge to surgery or a bridge to nowhere? Dig Dis Sci, 2020, 65(10): 2789-2799.
21. Han JG, Wang ZJ, Dai Y, et al. Short-term outcomes of elective surgery following self-expandable metallic stent and neoadjuvant chemotherapy in patients with left-sided colon cancer obstruction. Dis Colon Rectum, 2022 May 30. Online ahead of print. doi: 10.1097/DCR.0000000000002372.
22. Tamini N, Angrisani M, Aldè S, et al. Does preoperative stent positioning in obstructive left sided colon cancer increase the risk of perineural invasion? Updates Surg, 2021, 73(2): 547-553.
23. Sugiura K, Seo Y, Aoki H, et al. Bridge to surgery for obstructing colonic cancer: a comparison between right- and left-sided lesions. J Anus Rectum Colon, 2021, 5(1): 34-39.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Influence of surgical treatment on early postoperative anal function in left colon cancer patients with acute complete obstruction

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