A model for predicting outcomes of primary resection with colostomy in patients with acute colonic cancer obstruction

Abstract

Aim to create a model for predicting outcomes of resection with colostomy in patients with acute obturation colon obstruction caused by tumor. Material and methods.The study design was a retrospective multicenter analysis for the period from 2013 to 2020. At the first stage, we analyzed 3854 medical records of patients who were subject to emergent surgery in the surgical departments of the Samara region for acute colonic cancer obstruction, with tumor localized in the colon. We compared the outcomes of colon primary resection for tumor removal followed by colostomy and surgical treatment with colostomy without resection. At the second stage, we analyzed the complications risk factors in patients with colon primary resection for tumor removal followed by a single-barrel colostomy, n = 1936. Results.According to the study, the active surgical intervention had no statistically significant correlation to the increase in number of adverse outcomes. We identified the statistically significant risk factors for an unfavorable outcome after primary intestinal resection. These data allowed us to create and register a soft-ware "Automated system for determining the risk of primary intestinal resection in case of colonic cancer obstruction". The next stage of the study was planned for validation of the developed risk-predicting model, in patients being consistently admitted to on-duty surgical departments. Conclusion.The choice of the method of surgery for tumor colonic obstruction is preconditioned by the basic requirement the resolution of intestinal obstruction. In a number of cases, the primary resection of the intestine with a tumor and with the single-barrel colostomy can be performed. If it is possible to perform primary intestinal resection on the basis of traditional principles, the risk of its implementation should be assessed for postoperative complications using a standard method. At present, the standard method does not exist in clinical recommendations and requires development and implementation.