Pavlidis ET, Galanis IN, Pavlidis TE. Management of obstructed colorectal carcinoma in an emergency setting: An update. World J Gastrointest Oncol 2024; 16(3): 598-613 [PMID: 38577464 DOI: 10.4251/wjgo.v16.i3.598]
Corresponding Author of This Article
Theodoros E Pavlidis, Doctor, PhD, Emeritus Professor, Surgeon, 2nd Propedeutic Department of Surgery, Hippokration General Hospital, School of Medicine, Aristotle University of Thessaloniki, 49 Konstantinoupoleos, Thessaloniki 54642, Greece. pavlidth@auth.gr
Research Domain of This Article
Surgery
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Mar 15, 2024; 16(3): 598-613 Published online Mar 15, 2024. doi: 10.4251/wjgo.v16.i3.598
Management of obstructed colorectal carcinoma in an emergency setting: An update
Efstathios T Pavlidis, Ioannis N Galanis, Theodoros E Pavlidis
Efstathios T Pavlidis, Ioannis N Galanis, Theodoros E Pavlidis, 2nd Propedeutic Department of Surgery, Hippokration General Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54642, Greece
Author contributions: Pavlidis TE designed research, contributed new analytic tools, analyzed data and review; Galanis IN analyzed data and review; Pavlidis ET performed research, analyzed data, review and wrote the paper.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Theodoros E Pavlidis, Doctor, PhD, Emeritus Professor, Surgeon, 2nd Propedeutic Department of Surgery, Hippokration General Hospital, School of Medicine, Aristotle University of Thessaloniki, 49 Konstantinoupoleos, Thessaloniki 54642, Greece. pavlidth@auth.gr
Received: October 21, 2023 Peer-review started: October 21, 2023 First decision: December 6, 2023 Revised: December 6, 2023 Accepted: January 16, 2024 Article in press: January 16, 2024 Published online: March 15, 2024 Processing time: 143 Days and 3.2 Hours
Core Tip
Core Tip: Acute obstruction is common in patients with more advanced colorectal carcinoma and may be the first manifestation mainly of left-sided obstruction and in elderly individuals. Emergency decompression is mandatory. Emergency surgical resection and primary anastomosis accompanied or not accompanied by proximal defunctioning stoma must be the first treatment choice for fit patients under 70 years. Hartmann’s two-stage procedure, although more preferable, must be the second alternative choice. Emergency endoscopic self-expendable metal stents must be preferred in unfit patients as a bridge to surgery and for palliative treatment in all inoperable cases. However, these basic management principles constitute a general direction. Decision-making is important and should be individualized.
