Short-and Long-term Outcomes of Preoperative Decompression for Malignant Large Bowel Obstruction

Abstract

Background: Preoperative decompression for malignant large bowel obstruction (MLBO) can allow high-risk emergency surgery to be avoided and elective one-stage surgery without colostomy. However, its impact on the survival is unknown. We investigated the efficacy, in terms of the short- and long-term outcomes, of preoperative decompression as compared to emergency surgery for MLBO. Method：From January 2005 to December 2013, we retrospectively identified 163 patients who underwent surgery for MLBO. The patients were divided into two groups：the ED group (n=110), in which elective surgery was undertaken after preoperative decompression, and the ES group (n=53), in which emergency surgery was performed without preoperative decompression. Results：The clinical success rate of preoperative decompression was 74%. The colostomy rate in the ED group was significantly lower than that in the ES group (14% vs. 56%, p<0.01). There was no significant difference in terms of the morbidity or survival rate between the two groups. Conclusion：Preoperative decompression for MLBO can allow colostomy to be avoided and has no negative oncological impact.