One Stage Procedure versus Two Stages Procedure in Management of Obstructed Non-Perforated Cancer Colon

Abstract

Background: The surgical management of large bowel emergency patients remains controversial. However, there has been an increasing trend toward primary reconstructive surgery. Objective: To evaluate one-stage procedure versus two-stage procedure in cases presented with obstructed nonperforated cancer colon in terms of operative time, hospital stay, postoperative complications, peri-operative mortality, and quality of life. Patients and methods: A prospective randomized study was conducted at Emergency Mansoura University Hospitals. A total of 50 cases diagnosed with obstructed nonperforated cancer colon were randomly allocated into two groups; the first group included 25 cases who underwent the one-stage approach, and the second one included the remaining 25 cases who underwent the two-stage approach. Results: Although the two-staged approach showed an increase in operative time compared to the single-stage approach (174.88 vs. 163.84 min, respectively), that difference was statistically insignificant (P 1⁄4 0.102). Hospital stay showed significant prolongation in the single-stage group (5.8 vs. 3.88 days in the two-stage group e P < 0.001). No significant difference was detected between the study groups regarding postoperative complications. Mortality was encountered only in one case in the one-stage group (4%) due to pulmonary embolism. The prevalence of patient dissatisfaction was significantly higher in the two-stage group (48%) compared to the single-stage group (12%). Conclusion: We concluded no significant increase in perioperative morbidity or mortality rates in the one-stage procedure compared to the staged one when applied for obstructed cancer colon patients.