phenylephrine-hydrochloride and Colorectal-Neoplasms

Emergency surgical resection is a standard treatment for right-sided malignant colonic obstruction; however, the procedure is associated with high rates of mortality and morbidity. Although a bridge to surgery can be created to obviate the need for emergency surgery, its effects on long-term outcomes and the most practical management strategies for right-sided malignant colonic obstruction remain unclear.. To determine the appropriate management approach for right-sided malignant colonic obstruction.. Forty patients with right-sided malignant colonic obstruction who underwent curative resection from January 2007 to April 2017 were included in the study. We compared the perioperative and long-term outcomes of patients who received bridges to surgery established using decompression tubes and those created using self-expandable metallic stents (SEMS). The primary outcome was the overall survival duration (OS) and the secondary endpoints were the disease-free survival (DFS) duration and the preoperative and postoperative morbidity rates. Analysis was performed on an intention-to-treat basis.. There were 21 patients in the decompression tube group and 19 in the SEMS group. There were no significant differences in the perioperative morbidity rates of the two groups. The OS rate was significantly higher in the decompression tube group than in the SEMS group (5-year OS rate; decompression tube 79.5%, SEMS 32%,. The bridge to surgery using trans-nasal and trans-anal decompression tubes for right-sided malignant colonic obstruction is safe and may improve long-term outcomes.

Topics: Aged; Aged, 80 and over; Anal Canal; Colonic Diseases; Colorectal Neoplasms; Decompression, Surgical; Disease-Free Survival; Female; Follow-Up Studies; Humans; Intention to Treat Analysis; Intestinal Obstruction; Male; Middle Aged; Natural Orifice Endoscopic Surgery; Nose; Postoperative Complications; Retrospective Studies; Self Expandable Metallic Stents; Survival Rate; Treatment Outcome

The purpose of this study was to evaluate the safety and efficacy of palliative self-expanding metallic stent (SEMS) placement using a nasal endoscope technique in the context of colorectal malignant obstruction. Eighteen patients with malignant colorectal obstruction who underwent palliative SEMS insertion using a nasal endoscope technique at the Toyonaka Municipal Hospital from August 2005 to August 2011 were enrolled and retrospectively analyzed. In all cases, a guidewire could be inserted on the oral side of the tumor. The placement success rate was 94.4% (17/18), and the complication rate was 23.5% (4 cases). The stent migrated in 3 cases, and perforation occurred in 1 case following bevacizumab chemotherapy. These outcomes indicate that stenting is useful for terminal patients and that nasal endoscopy is useful in cases of difficult guidewire placement.

Topics: Aged; Aged, 80 and over; Colorectal Neoplasms; Endoscopy; Female; Humans; Intestinal Obstruction; Male; Middle Aged; Nose; Palliative Care; Retrospective Studies; Stents; Treatment Outcome

Topics: Colorectal Neoplasms; Humans; Nasal Polyps; Nasopharyngeal Neoplasms; Nose