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Clinical characteristics of ischemic colitis after surgery for colorectal cancer

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Abstract

Purpose

This study was performed to clarify the clinical features of ischemic colitis (IC) after colorectal cancer surgery.

Methods

This study retrospectively reviewed the medical records of 35 patients with IC. Patients were divided into two groups: those who had undergone colorectal cancer surgery (POIC group, n = 13) and those who had not undergone colorectal cancer surgery (NOIC group, n = 22). Gangrenous colitis was seen in one patient in the POIC group, and transient colitis was seen in the remaining 34 patients.

Results

Among the patients with transient colitis, there were significantly more patients without underlying diseases or promoting factors in the POIC group than in the NOIC group (P = 0.01). Abdominal pain was more frequently reported in the NOIC group than in the POIC group as both the initial symptom (P = 0.02) and throughout the disease course (P = 0.02). Ischemic changes occupying more than half the circumference of the intestinal wall were more frequently found in the NOIC group than in the POIC group (P = 0.03).

Conclusions

Although transient POIC may occur without any underlying disease, severe symptoms rarely occur. However, if POIC occurs in a patient with severe underlying disease, then the occurrence of severe colitis should be considered.

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References

  1. Jemal A, Tiwari RC, Murray T, Ghafoor A, et al. Cancer statistics. CA Cancer J Clin. 2004;54:8–29.

    Article  PubMed  Google Scholar 

  2. Kotake K, Honjo S, Sugihara K, et al. Changes in colorectal cancer during a 20-year period: an extended report from the multi-institutional registry of large bowel cancer, Japan. Dis Colon Rectum. 2003;46(Suppl):32–43.

    Google Scholar 

  3. Boley SJ, Schwarz S, Lash J, Sternhill V. Reversible vascular occlusion of the colon. Surg Gynecol Obstet. 1963;116:53–60.

    CAS  PubMed  Google Scholar 

  4. Candhi SK, Hanson MM, Vernava AM, Kaminski DL, Longo WE. Ischemic colitis. Dis Colon Rectum. 1996;39:88–100.

    Article  Google Scholar 

  5. Montolo MA, Brandt LJ, Santolaria SB, Gomollon F, Sanchez-Puertolas B, Vera J. et. Clinical pattern and outcomes of ischemic colitis: results of the working group for study for the Study of Ischemic Colitis in Spain (CIE study). 2011;46:236–46.

    Google Scholar 

  6. Fernandez JC, Calvo LN, Vazquez EG, Garcia MJG, Perez MTA, Silva IM, et al. Risk factors associated with development of ischemic colitis. World J Gastroenterol 2010;164564–4569.

  7. Higgins PDR, Davis KJ, Laine L. Systematic review: the epidemiology of ischemic colitis. Aliment Pharmacol Ther. 2004;19:729–38.

    Article  CAS  PubMed  Google Scholar 

  8. Scharff JR, Longo WE, Vartanian SM, Jacobs DL, Bahadursingh AN, Kaminski DL. Ischemic colitis: spectrum of disease and outcome. Surgery. 2003;134:624–9.

    Article  PubMed  Google Scholar 

  9. Huerta C, Rivero E, Montoro MA, Garcia-Rodriguez LA. Risk factors for intestinal ischemia among patients registered in a UK primary care database: a nested case–control study. Aliment Pharmacol Ther. 2011;33:969–78.

    Article  CAS  PubMed  Google Scholar 

  10. Yasuhara H. Acute mesenteric ischemia: the challenge of gastroenterology. Surg Today. 2005;35(3):185–95.

    Article  PubMed  Google Scholar 

  11. Bower TC. Ischemic colitis. Surg Clin N Am. 1993;73:1037–53.

    CAS  PubMed  Google Scholar 

  12. Yamazaki T, Shirai Y, Sakai Y, Hatakeyama K. Ischemic stricture of the rectosigmoid colon caused by division of the superior rectal artery below Sudeck’s point during sigmoidectomy: report of a case. Surg Today. 1997;27(3):254–6.

    Article  CAS  PubMed  Google Scholar 

  13. Japan Society for Cancer of the Colon and Rectum, editors. General rules for clinical and pathological studies on cancer of the colon, rectum and anus. 7th ed. Revised version, Tokyo: Kanehara Shuppan; 2009.

  14. Iida M, Matsumoto T, Hirota C, Aoyanagi K, Tominaga M, Iwashita A. New approaches to ischemic lesion of the intestine. Clinical features of ischemic lesions of the intestine: focused on ischemic colitis (in Japanese). Stomach and Intestine. 1993;28:899–911.

    Google Scholar 

  15. Higgins PD, Davis KJ, Laine L. Systematic review: the epidemiology of ischemic colitis. Aliment Pharmacol Ther. 2004;19:729–38.

    Article  CAS  PubMed  Google Scholar 

  16. Elder K, Lashner BA, Al Solaiman F. Clinical approach to colonic ischemia. Cleve Clin J Med. 2009;76:401–9.

    Article  PubMed  Google Scholar 

  17. Park MG, Hur H, Min BS, Lee KY, Kim NK. Colonic ischemia following surgery for sigmoid colon and rectal cancer: a study of 10 cases and a review of the literature. Int J Colorectal Dis. 2012;27(5):671–5.

    Article  PubMed  Google Scholar 

  18. Walker AM, Bohn RL, Cali C, Cook SF, Ajene AN, Sands BE. Risk factor for colon ischemia. Am J Gastroenterol. 2004;99:1333–7.

    Article  PubMed  Google Scholar 

  19. Suh DC, Kahler KH, Choi IS, Shin H, Kralstein J, Shetzline M. Patients with irritable bowel syndrome or constipation have an increased risk for ischemic colitis. Aliment Pharmacol Ther. 2007;25:681–92.

    Article  PubMed  Google Scholar 

  20. Habu Y, Tahashi Y, Kiyota K. Reevaluation of clinical features of ischemic colitis—analysis of 68 consecutive cases diagnosed by early colonoscopy. Scand J Gastroenterol. 1996;31:881–6.

    Article  CAS  PubMed  Google Scholar 

  21. Matsumoto T, Iida M, Kimura Y, Nanbu T, Fujishima M. Clinical features in young adult patients with ischemic colitis. J Gastroenterol Hepatol. 1994;9:572–5.

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest

Harunobu Sato and the co-authors have no conflicts of interest to declare in association with this study.

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Correspondence to Harunobu Sato.

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Sato, H., Koide, Y., Shiota, M. et al. Clinical characteristics of ischemic colitis after surgery for colorectal cancer. Surg Today 44, 1090–1096 (2014). https://doi.org/10.1007/s00595-013-0661-y

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  • DOI: https://doi.org/10.1007/s00595-013-0661-y

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