ABSTRACT
PURPOSE: Since oncological outcomes of transanal colorectal tube (TCT) placement, an endoscopic treatment for colorectal cancer (CRC) with acute colorectal obstruction (ACO), remain unknown, this study analyzed long-term outcomes of TCT placement for stage II/III CRC with ACO. MATERIALS AND METHODS: Data were retrospectively reviewed from consecutive patients with distal stage II/III CRC who underwent surgery between January 2007 and December 2011 at two Japanese hospitals. One hospital conducted emergency surgery and the other performed TCT placement as the standard treatment for all CRCs with ACO. Propensity score (PS) matching was used to adjust baseline characteristics between two groups. RESULTS: Among 754 patients with distal stage II/III CRC, 680 did not have ACO (non-ACO group) and 74 had ACO (ACO group). The PS matching between both hospitals identified 234 pairs in the non-ACO group and 23 pairs in the ACO group. In the non-ACO group, the surgical quality was equivalent between the two institutions, with no significant differences in overall survival (OS) and disease-free survival (DFS). In the ACO group, the rate of primary resection/anastomosis was higher in the TCT group than in the surgery group (87.0% vs. 26.1%, p < 0.001). No significant differences were noted between the surgery and the TCT groups in OS (5-year OS, 61.9% vs. 51.5%; p=0.490) and DFS (5-year DFS, 45.9% vs. 38.3%; p=0.658). CONCLUSION: TCT placement can achieve similar long-term outcomes to emergency surgery, with a high rate of primary resection/anastomosis for distal stage II/III colon cancer with ACO.
Subject(s)
Humans , Asian People , Colon , Colonic Neoplasms , Colorectal Neoplasms , Disease-Free Survival , Emergencies , Propensity Score , Retrospective StudiesABSTRACT
The effects of local application of capsaicin (CAP) to peripheral nerves on electroacupuncture (EA) analgesia were behaviorally examined in the rats. Pain threshold, datermined by using a hot-plate and tail-flick methods, increased to 160-180% of the control value after EA, which was applied to the acupuncture points between LI-11 and LI-12 of the rat forepaw. After the local application of CAP to the radial, ulner and median nerves of the animal's right forepaw, the EA, applied to the treated forepaw, did not significantly change the pain threshold. In the same animals, the EA applied to the untreated side increased the threshold as high as that before the CAP treatment. This indecates that the EA became ineffective on the CAP treated side, this ineffectiveness of the EA cont inued until at last 15 days in the case of the single CAP treatment for 15min, on the peripheral nerves. The substance P (SP) concentration in the spinal dolsal horn (C5-7) of these animals, which was measured by radioimmunoassay, was about 40% lower in the CAP treated side than in the untreated side.<br>These results suggest that SP-containing primary afferents, of which nerve conduction was probably blocked by treatment whth CAP, convey information for EA analgesia.