Key result
Temporary decompression with a diverting colostomy at the first stage decreases perioperative mortality and improves quality of life and overall survival in elderly patients with obstructive left colon cancer.
Why the study?
Acute bowel obstruction is the most common complication of left colon cancer, frequently affecting patients over 75 years, but the optimal surgical approach in this group remains debatable.
Does temporary decompression via diverting colostomy at the first stage improve morbidity, mortality, and oncological outcomes in elderly and octogenarian patients with acute left-sided malignant large bowel obstruction compared to emergency surgery or stenting?
Does temporary decompression via diverting colostomy at the first stage improve morbidity, mortality, and oncological outcomes in elderly and octogenarian patients with acute left-sided malignant large bowel obstruction compared to emergency surgery or stenting?
Temporary decompression via diverting colostomy at the first stage is a safe and effective approach for acute left-sided malignant bowel obstruction in elderly patients, reducing perioperative mortality and permanent stoma rates.
Supports staged diverting colostomy in elderly patients; leaves open need for prospective RCTs.
Acute bowel obstruction is the most common complication of left colon cancer, with the age of patients with this pathology in most cases being over 75 years. The optimal surgical approach in this group of patients remains debatable. A search of scientific studies on the treatment of left-sided malignant obstruction in elderly and octogenarian patients was done in the Elibrary.ru, PubMed, and Medline databases from 2008 to 2023. To date, there is no irrefutable evidence to support whether emergency surgery or colonic stent placement is optimal treatment in terms of the morbidity, mortality and late oncological outcomes. A current solution to the problem can be temporary decompression of the bowel. The literature demonstrates advantages of diverting colostomy at the first stage in decrease in perioperative mortality, an improvement in the quality of life due to a decreased morbidity and mortality rate, good oncological.
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Эфрон et al. (2025) conducted a review in Acute left-sided colon tumor obstruction. Diverting colostomy (decompression stoma) as a first stage vs. Emergency resection or colonic stenting was evaluated on Perioperative mortality, morbidity, and long-term oncological outcomes. Temporary decompression with a diverting colostomy at the first stage decreases perioperative mortality and improves quality of life and overall survival in elderly patients with obstructive left colon cancer.
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