title: Outcomes for patients with obstructing colorectal cancers treated with one-stage surgery using transanal drainage tubes.
abstract: BACKGROUND
  Acute colorectal obstruction requires immediate surgical treatment. Although one-stage surgery with transanal drainage tubes (TDT) is reportedly safe and feasible, the long-term outcome of this procedure remains unclear.
  
  
  OBJECTIVE
  To assess the outcome of one-stage surgery using TDT in the acute left colon or rectal obstructions due to colorectal carcinomas.
  
  
  METHODS
  Clinicopathological data were recorded from patients with colorectal cancer with acute obstructions between 2006 and 2013.
  
  
  RESULTS
  A total of 43 patients were enrolled including 29 males and 14 females. Among 39 patients, TDT was successful in 33 (84 %) and was incomplete in 6. Thus, 33 patients received one-stage surgery with TDT decompression, and 9 patients, including 6 with incomplete decompression, received one-stage surgery with no decompression. No significant differences in clinicopathological factors were observed between decompression and non-decompression groups. Adjusted analyses revealed that decompression using TDT was significantly associated with OS (hazard ratio 0.24; 95 % confidence interval, 0.08-0.72; p = 0.01). Furthermore, OS in the TDT decompression group was significantly longer than that in the non-decompression group (p = 0.01).
  
  
  CONCLUSIONS
  One-stage surgery with decompression using TDT may be effective to avoid stomas and to improve overall survival in patients with obstructing colorectal cancers.
authors.affiliation: Department of Surgery, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama-shi, Saitama, 336-8522, Japan, ohlkoh@gmail.com.
authors.forename: Kohei
authors.initials: K
authors.lastname: Shigeta
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yamafuji
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kaneda
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Katsura
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Kubochi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy; D015179:Colorectal Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D004322:Drainage / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome