Acute obstructive large-bowel obstruction in older patients: current diagnostic and treatment methods (a literature review)
DOI:
https://doi.org/10.14739/2310-1210.2025.6.326985Keywords:
surgical procedures, computed tomography, elderly, oncologyAbstract
Intestinal obstruction is the most common complication of colon cancer. Today, one of the ways to improve treatment outcomes in older patients is to use a multidisciplinary approach with a wide range of clinical and diagnostic methods to determine the patient’s functional status and diagnose comorbidities. This requires the use of an individualized treatment approach to colon obstruction.
Aim. To review current evidence from the scientific literature on methods of diagnosis and treatment for acute obstructive colonic obstruction in older patients over the last 8 years.
Materials and methods. The work is based on the processing of the results and analysis of modern clinical practice guidelines, published clinical studies on the latest methods of diagnosis and treatment of acute obstructive colon obstruction in elderly and geriatric patients on the platforms MEDLINE, Google Scholar, PubMed, EMBASE and the Cochrane Database available between 2016 and 2024.
Results. One of the best methods for diagnosing colon obstruction is computed tomography, which is considered the “gold standard” for diagnosis. In stable patients, direct visualization of colon obstruction should be considered if colonoscopy is accessible. Biopsy is recommended prior to planned surgical intervention. The methodology used in most studies regarding minimally invasive approaches in the elderly has an uncertain degree of selection bias, which may partially explain some of the reported improved outcomes associated with laparoscopy. A multimodal approach using endoscopic and laparoscopic procedures has demonstrated favorable short-term outcomes when placing a stent as a bridge to surgery, providing a less invasive alternative to multistage open surgery.
Conclusions. Acute intestinal obstruction often necessitates emergency surgical intervention. Thanks to advances in surgical and systemic therapy, as well as a better understanding of the obstruction process biology, an increasing number of patients may achieve long-term survival. Minimally invasive surgical techniques are safe for elderly patients, however, further research is warranted.
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