Evidence-based treatment of patients with acute large bowel obstruction caused by colon cancer of the left colon: Applying a clinical decision guideline

Evidence-based treatment of patients with acute left-sided malignant colonic obstruction: Applying a clinical decision guideline

Status

Active, not recruiting

Phases

Unknown

Study type

Observational

Source

NL-OMON

Registry ID

NL-OMON26596

Enrollment

195

Registered

2014-07-07

Start date

2015-01-01

Completion date

Unknown

Last updated

2024-02-28

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Colon cancer, malignant large bowel obstruction, stent, elderly patients. Dutch: Obstructief coloncarcinoom, stent, ouderen.

Interventions

1. Patients younger than 70 years will have surgical resection. Exceptions can be made for those who have (1) an indication for neo-adjuvant treatment, (2) severe comorbidities, and (3) incurable meta

they should receive a decompressing intervention. 2. Patients aged 70 years and older without incurable metastatic disease will initially have non-resectional decompression followed by elective resec

Eligibility

Inclusion criteria

Inclusion criteria: Patients with symptomatic malignant obstruction of the left colon (including the splenic flexure, descending colon and sigmoid) caused by colonic cancer who require an urgent intervention to alleviate the obstruction.

Exclusion criteria

Exclusion criteria: - Suspicion of peritonitis due to perforation (tumour or cecum blow out). - Patients with benign disease at pathology. - Patients with obstruction caused by extracolonic malignancy. - Patients with malignant obstruction of the right colon, i.e. proximal to the splenic flexure. - Patients with obstruction caused by rectal cancer, as defined within 10 cm of the anal verge for this protocol.

Design outcomes

Primary

Measure	Time frame
In-hospital and 30-day mortality rate in the elderly patients (≥ 70 years).	—

Secondary

Measure	Time frame
- Morbidity and stoma rates. - The technical and clinical success rates, incidence of guidewire and stent perforation and morbidity of delayed surgery of colorectal stenting. - The oncologic quality of surgical resection in terms of lymph node harvest and radicality. - Outcome (morbidity, mortality, stoma rates, survival) of conservative, non-resectional management of patients with incurable disease or high operative risk that are treated according to the clinical decision guideline with either a colorectal stent or stoma alone.	—

Measure

Time frame

- Morbidity and stoma rates. - The technical and clinical success rates, incidence of guidewire and stent perforation and morbidity of delayed surgery of colorectal stenting. - The oncologic quality of surgical resection in terms of lymph node harvest and radicality. - Outcome (morbidity, mortality, stoma rates, survival) of conservative, non-resectional management of patients with incurable disease or high operative risk that are treated according to the clinical decision guideline with either a colorectal stent or stoma alone.

—

Contacts

Public ContactE.E. Halsema, van

e.e.halsemavan@amc.nl+31(0)205668708

Outcome results

None listed

Source: NL-OMON (via WHO ICTRP)