Transanal Decompression Tube Versus Stent for Acute Malignant Left-sided Colonic and Rectal Obstruction

Transanal Decompression Tube Versus Stent for Acute Malignant Left-sided Colonic and Rectal Obstruction

Transanal Decompression Tube Versus Stent as a Bridge to Surgery for Acute Malignant Left-sided Colonic and Rectal Obstruction

The purpose of this study is to compare the clinical outcomes of transanal decompression tube as a bridge to surgery with stent as a bridge to surgery for acute malignant left-sided colonic and rectal obstruction.

Approximately 8-47 % of patients with colorectal cancer will present with colonic obstruction. Left-sided colonic and rectal cancer is responsible for nearly 70% of acute colonic obstruction. Emergency colonic surgery for acute obstruction is associated with a higher mortality and morbidity rate than elective surgery. Preoperative decompression results in a less dilated bowel that is more amenable to an elective surgery. Both transanal decompression tube and stent can serve a good preoperative decompression effect and serve a good bridge to surgery. Investigators aim to compare the clinical outcomes of transanal decompression tube as a bridge to surgery with stent as a bridge to surgery for acute malignant left-sided colonic and rectal obstruction.

From the date of randomization until the date of first documented creation of stoma, assessed up to 24 months

Transanal decompression tube/stent-related complications usually include bowel perforation, migration, and stent re-obstruction.

From the date of randomization until the date of first documented transanal decompression tube/stent-related complication, assessed up to 7 days

From the date of randomization until the date of first documented surgery-related complication, assessed up to 24 months

Inclusion Criteria: definite diagnosis of left-side colonic or rectal obstruction; symptomatic colonic obstruction for less than 1 week; colonic obstruction caused by a histologically proven malignant colonic tumor Exclusion Criteria: suspected benign colonic or rectal obstruction; right-side colonic obstruction; patients with signs of peritonitis; dysfunction of blood coagulation, active bleeding, active infection, and significant cardiac or pulmonary disease; patients who do not want to undergo surgery.

Xu YS, Song T, Guo YT, Shao GQ, Du HT, Li DC, Fu YF. Placement of the Decompression Tube as a Bridge to Surgery for Acute Malignant Left-Sided Colonic Obstruction. J Gastrointest Surg. 2015 Dec;19(12):2243-8. doi: 10.1007/s11605-015-2936-7. Epub 2015 Sep 9.