Trends in emergency surgical management of obstructive colon cancer. Situation in the Department of Santander, Colombia, and current considerations
DOI:
https://doi.org/10.35509/01239015.803Keywords:
colonic neoplasms; colonic diseases; anastomosis, surgical, colorectal surgery, colostomy, sigmoid neoplasms.Abstract
Objectives: Report the surgeon´s surgical trends in the department of Santander and analyze the regional situation for obstructive colon cancer in the emergency department setting. Methods: A digital questionnaire was used to gather information about each surgeon's preference in the surgical management of obstructive colon cancer in different locations in the emergency setting. Demographic variables are described, as well as the trends in the different management options. Associations between demographic variables and surgical behavior were analyzed using the Chi2 and Fisher exact tests. Results: Sample of 32 surgeons with a mean age of 46.15 ± 11.48 years, 75% men, with 1 to 35 years of experience. For right colon obstructions, the trend was to perform right hemicolectomy and ileocolic anastomosis (90.6%); for transverse colon, transverse hemicolectomy and anastomosis (65.6%); in the case of the left colon, more proximal locations led to a comparable trend for ostomy or primary anastomosis (53.1% vs. 46.9% respectively) and for more distal locations (sigmoid and rectosigmoid junction), the trend is to perform of ostomies (78.1% vs. 100% respectively). 71.9% of surgeons refer to performing oncological resection in the emergency setting. In the bivariate analysis, an association was found between the surgeon's age and the type of procedure for obstructive neoplasms of the right colon, with a greater tendency (66%) to perform ostomies in surgeons> 50 years. Conclusions: The surgical trend in the group of surgeons from the department of Santander is in accordance with the international management guidelines regarding the management of tumors of the right and transverse colon with a greater tendency to resection and primary anastomosis, however, it was identified greater preference to perform ostomies in distal left tumor lesions. In general, the current recommendations are aimed at resection and anastomosis in the first surgical stage in all scenarios, however, other factors depending on each patient and the hospital setting, independent of the surgeon's surgical trend, must be taken into account.Author Biographies
Silvia Guerrero-Macías, Universidad Militar Nueva Granada, Bogotá, D.C., Colombia.
1. Universidad Militar Nueva Granada, Bogotá, D.C., Colombia.
2. Instituto Nacional de Cancerología, Bogotá, D.C., Colombia.
3. Departamento de Cirugía General, Universidad Industrial de Santander, Bucaramanga, Colombia.
Ada Bustos-Guerrero, Universidad Industrial de Santander, Bucaramanga, Colombia.
4. Universidad Industrial de Santander, Bucaramanga, Colombia.
Andrés Chaparro-Zaraza, Universidad Industrial de Santander, Bucaramanga, Colombia.
4. Universidad Industrial de Santander, Bucaramanga, Colombia.
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