BACKGROUND/AIMS: The prematurely closed Stent-In II trial in patients with left-sided obstructive colon cancer may have influenced clinical decision making in The Netherlands. The aim of this study was to evaluate treatment of left-sided malignant colon obstruction at a population level since then. METHODS: Short-term outcomes of all patients who underwent resection for left-sided obstructive colon cancer between 2009 and 2012 were assessed based on a prospective national registry. RESULTS: In total, 1,816 evaluable patients were included; acute resection was performed in 1,485 (81.8%), and endoscopic stent or decompressing stoma followed by resection in 196 (10.8%) and 135 (7.4%), respectively. The use of endoscopic stenting significantly decreased from 18% (2009) to 6% (2012). Overall 30-day or in-hospital mortality rate was 6.9, 5.6, and 3.7%, respectively (p = 0.107). Mortality rate after acute resection was 2.9% in patients <70 [corrected] years, but mortality rates up to 32.2% were observed in high-risk elderly patients. CONCLUSION: Acute resection as first choice treatment seems justified for patients <70 [corrected] years of age given a mortality rate of 3%. For the elderly frail patients, mortality rates over 30% after acute resection stress the need for alternative treatment strategies.
BACKGROUND/AIMS: The prematurely closed Stent-In II trial in patients with left-sided obstructive colon cancer may have influenced clinical decision making in The Netherlands. The aim of this study was to evaluate treatment of left-sided malignant colon obstruction at a population level since then. METHODS: Short-term outcomes of all patients who underwent resection for left-sided obstructive colon cancer between 2009 and 2012 were assessed based on a prospective national registry. RESULTS: In total, 1,816 evaluable patients were included; acute resection was performed in 1,485 (81.8%), and endoscopic stent or decompressing stoma followed by resection in 196 (10.8%) and 135 (7.4%), respectively. The use of endoscopic stenting significantly decreased from 18% (2009) to 6% (2012). Overall 30-day or in-hospital mortality rate was 6.9, 5.6, and 3.7%, respectively (p = 0.107). Mortality rate after acute resection was 2.9% in patients <70 [corrected] years, but mortality rates up to 32.2% were observed in high-risk elderly patients. CONCLUSION: Acute resection as first choice treatment seems justified for patients <70 [corrected] years of age given a mortality rate of 3%. For the elderly frail patients, mortality rates over 30% after acute resection stress the need for alternative treatment strategies.
Authors: Femke Julie Amelung; Werner Adriaan Draaisma; Esther Catharina Josephina Consten; Peter Derk Siersema; Frank Ter Borg Journal: Surg Endosc Date: 2017-04-13 Impact factor: 4.584
Authors: Femke J Amelung; Frank Ter Borg; Esther C J Consten; Peter D Siersema; Werner A Draaisma Journal: Surg Endosc Date: 2016-04-12 Impact factor: 4.584
Authors: Joyce V Veld; Femke J Amelung; Wernard A A Borstlap; Emo E van Halsema; Esther C J Consten; Peter D Siersema; Frank Ter Borg; Edwin S van der Zaag; Johannes H W de Wilt; Paul Fockens; Wilhelmus A Bemelman; Jeanin E van Hooft; Pieter J Tanis Journal: JAMA Surg Date: 2020-03-01 Impact factor: 14.766
Authors: Femke J Amelung; Charlotte L J Mulder; Ivo A M J Broeders; Esther C J Consten; Werner A Draaisma Journal: Int J Colorectal Dis Date: 2016-11-12 Impact factor: 2.571
Authors: Jeske R E Boeding; Winesh Ramphal; Rogier M P H Crolla; Leandra J M Boonman-de Winter; Paul D Gobardhan; Jennifer M J Schreinemakers Journal: Int J Colorectal Dis Date: 2018-07-25 Impact factor: 2.571