1. Low incidence of occult colorectal carcinoma in a cohort of 150 consecutive patients with diverticular strictures.
- Author
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Connelly TM, Cheong JY, Lincango EP, Foley N, Clancy C, Valente M, and Kessler H
- Subjects
- Humans, Female, Middle Aged, Aged, Aged, 80 and over, Male, Constriction, Pathologic epidemiology, Constriction, Pathologic etiology, Constriction, Pathologic surgery, Retrospective Studies, Incidence, Colonoscopy, Diverticulum, Colorectal Neoplasms complications, Colorectal Neoplasms epidemiology, Colorectal Neoplasms surgery
- Abstract
Background: The symptoms of stricturing diverticulitis can overlap with those of colorectal cancer. Additionally, the stricture itself may mask a "hidden" colorectal cancer. We aimed to describe the demographics, operative details and outcomes, including occult colorectal cancer, in a cohort of consecutive resections for presumed diverticular strictures., Methods: In this single-center, retrospective cohort study, all patients undergoing resection for a presumed diverticular stricture between January 2010 and December 2015 were included. Preoperative imaging and colonoscopies were individually reviewed. Only patients with radiographically, endoscopically and/or intraoperatively benign-appearing strictures were included., Results: One hundred fifty patients (72.7% female, mean age = 70.4 ± 11.8 years, 62.7% elective) were included. Only 34 (22.7%) had a complete preoperative colonoscopy. In 95 (63.6% of cohort) patients, the stricture was non-traversable colonoscopically. Overall, 47 (31.3%) patients did not have complete preoperative imaging or a colonoscopy. In total, 53.3% were open procedures and 62% had non-diverted primary anastomosis. Eleven (14.7%) underwent resection of adjacent organs (5 appendixes/5 right colons/7 fallopian tubes ± ovaries/3 small bowel resections/2 partial cystectomies/1 spleen). The median length of stay was 7 (5, 12.5) days. Only 2 cancers (1.3% of patients) involving the stricture (1 invasive moderately differentiated sigmoid adenocarcinoma/1 lymphoma) were found. Three additional cancers were found in organs involved in the inflammatory process (20% of concomitantly resected organs, 1 ovarian carcinoma/1 leukemia in a lymph node/1 appendiceal tumor)., Conclusion: Despite approximately one-third of the cohort not having undergone successful preoperative colonoscopy or imaging, the rate of neoplasia involving diverticular strictures was only 1.3%. A relatively high cancer rate was found in concomitantly resected organs involved in the stricturing process., (Copyright © 2023 Elsevier Inc. All rights reserved.)
- Published
- 2023
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