title: [Surgical management of malignant large bowel obstructions].
abstract: BACKGROUND
  Despite significant progress, the management of acute colonic obstruction still remains a challenging problem. The purpose of this study was represented by the evaluation of the clinical results of different techniques of resection for malignant colorectal (primary or staged) obstruction.
  
  
  METHODS
  We performed a non-randomized clinical study. 590 patients with malignant colorectal occlusion who underwent surgery treatment an 3rd Surgical Clinic Cluj-Napoca between 1996-2005 were included.
  
  
  RESULTS
  Patients with large bowel obstruction underwent one-stage primary resection with anastomosis in 267 cases or staged interventions in 323 cases. The groups were matched in: age, sex, comorbidities, tumor staging, serum preoperative levels of hemoglobin and proteins. The analysis of mortality and morbidity following surgical treatment for large bowel obstruction returned no significant difference among the two groups (p > 0.05). Moreover, the presented results showed a higher incidence of mortality (11.45% vs 9.33 %), morbidity (25.38% vs 14.6%) and increased hospitalization period (p = 0.029) among the patients that undergone seriate resections.
  
  
  CONCLUSIONS
  One stage primary resections with anastomosis of the large bowel can be performed safely in case of emergency whenever patient comorbidities and local conditions do not stand as major restrictions.
authors: Clinica Chirurgie III, Universitatea de Medicină si Farmacie "Iuliu Haţieganu", Cluj-Napoca, România.
authors: F
authors: F
authors: Zaharie
authors: L
authors: L
authors: Mocan
authors: T
authors: T
authors: Mocan
authors: C
authors: C
authors: Tomus
authors: V
authors: V
authors: Hodor
authors: N
authors: N
authors: Al Hajjar
authors: D
authors: D
authors: Munteanu
authors: I
authors: I
authors: Puia
authors: O
authors: O
authors: Bala
authors: R
authors: R
authors: Zaharie
authors: O
authors: O
authors: Ilie
authors: D
authors: D
authors: Bartos
authors: A
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authors: Bartos
authors: L
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authors: Vlad
authors: C
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authors: Iancu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods; D003110:Colonic Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome