Waiting Time to Chemotherapy in Obstructed Metastatic Colorectal Cancer: Comparative Analysis of 3 Surgical Procedures

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Prawaet Sangwanloy


Background: Surgical treatments in obstructed metastatic colorectal cancer (CRC) include primary resection with anastomosis, loop colostomy and
Hartmann’s procedure. Recovery of these  surgeries should not delay the conversion chemotherapy for bridging to metastectomy that improve the survival time.

Objective: To compare the postoperative waiting time for chemotherapy, length of stay, complication, and survival time between 3 groups of surgical procedures in obstructed metastatic CRC.

Material and methods: A retrospective cohort study was conducted among 50 patients with obstructed metastatic CRC who underwent surgery and received chemotherapy in Nan Hospital from 2011 to 2020. Length of stay, waiting time for chemotherapy, and survival time were compared between 3 surgical procedures using one-way ANOVA and Kruskal-Wallis test.

Results: The mean age was 62.4 years (SD 10.2, range 45−85) and 32 cases were male. Most of CRC located at rectum (34%), descending colon (26%) and sigmoid colon (18%). Metastatic sites were liver (74%) and lung (40%). Surgeries included 24 cases of primary resection with anastomosis, 19 cases of loop colostomy and 7 cases of Hartmann’s procedure. Length of stay were averaged 11.0 days (SD 4.4), 7.3 days (SD 2.9) and 7.7 days (SD 2.4) respectively (p=0.002). The mean waiting time for chemotherapy was 25.3 days (SD 6.6) in anastomosis group, 29.8 days (SD 14.1) in loop colostomy and 23.0 days (SD 27.4) in Hartmann’s procedure (p=0.416). The median survival time were 372 days (IQR 256, 661), 373 days (IQR 338, 545) and 657 days (IQR 245, 786) respectively (p=0.874). There were 1 case of sepsis and 1 case of surgical site infection in the anastomosis group, and 1 case of respiratory failure in loop colostomy group.

Conclusion: Primary resection with anastomosis in obstructed metastatic CRC did not delay the waiting time for conversion chemotherapy, compared with loop colostomy or Hartmann’s procedure.


Article Details

How to Cite
Sangwanloy, P. (2022). Waiting Time to Chemotherapy in Obstructed Metastatic Colorectal Cancer: Comparative Analysis of 3 Surgical Procedures. Lampang Medical Journal, 43(1), 1–6. Retrieved from https://he01.tci-thaijo.org/index.php/LMJ/article/view/252633
Original Article


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