Colorectal cancer is the third leading cause of cancer death in both men and women in the United States and the second leading cause of cancer death in men and the third leading cause of cancer death in women in Europe. Worldwide, colorectal cancer is responsible for 19.0 million (18.5-19.5) disability-adjusted life years (DALYs). The risk of developing colorectal cancer increases into old age. More than half of patients develop the disease after the age of 70, and only about 10% of cancers occur before the age of 55. About 20 % of patients initially present with acute colonic obstruction, which is one of the most common causes of surgical emergencies. International guidelines do not agree on the optimal treatment for left-sided obstructing colon cancer. In general, two therapeutic approaches are common: Emergency single-stage resection of the obstructing tumour, with or without creation of a stoma, or two-stage resection with a decompressive stoma creation in the first stage and elective oncological resection after convalescence in the second stage, usually after about 20-30 days. Both procedures have advantages and disadvantages.
Data from recent retrospective studies suggest that the two-stage bridge-to-surgery (BTS) approach may reduce 90-day mortality and long-term survival in patients with left-sided obstructive colon cancer. In addition to reducing mortality, BTS may also reduce the number of patients requiring a permanent stoma and facilitate the performance of minimally invasive colon resection, leading to a higher quality of life.
