{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T22:27:54Z","timestamp":1788820074947,"version":"build-2803163510"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[1985,4,1]],"date-time":"1985-04-01T00:00:00Z","timestamp":481161600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Downs Surgical Ltd; the Jessie Williment Bequest; the Locally Organized Research Scheme, North West Thames Regional Health Authority; and the Cancer Research Campaign"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1985,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Of 4583 patients in the Large Bowel Cancer Project, 713 (16 per cent) were obstructed. The site of greatest risk was the splenic flexure (49 per cent). Advanced stage was neither the full reason why some patients obstructed nor for their subsequent poor prospects (age-adjusted 5-year survival: not obstructed, 45 per cent; obstructed, 25 per cent). Also, there was no greater risk of vascular invasion, no heavier lymph node burden and no worse tumour differentiation in patients with obstruction. In-hospital mortality was high (23 per cent), was not reduced by either a policy of primary or staged resection and was not influenced by the site of obstruction. There was no survival advantage for either policy, but hospital stay after primary resection was half that of staged. Immediate anastomosis in the obstructed left colon had a high clinical leak rate (18 per cent versus 6 per cent elective; P &amp;lt; 0\u00b7001). Both registrars and consultants had similar mortality rates for elective primary resection and for the management of obstruction itself (as evidenced by results after the first stage of a staged resection). Selection probably accounts for the very much better results achieved by consultants for primary resection in the presence of obstruction (in-hospital mortality: consultants, 13 per cent; registrars, 24 per cent).<\/jats:p>","DOI":"10.1002\/bjs.1800720417","type":"journal-article","created":{"date-parts":[[2007,3,3]],"date-time":"2007-03-03T04:44:48Z","timestamp":1172897088000},"page":"296-302","source":"Crossref","is-referenced-by-count":316,"title":["Malignant large bowel obstruction"],"prefix":"10.1093","volume":"72","author":[{"given":"R K S","family":"Phillips","sequence":"first","affiliation":[{"name":"The Large Bowel Cancer Project, St Mary's Hospital , Praed Street, London W2 1NY,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Hittinger","sequence":"additional","affiliation":[{"name":"The Large Bowel Cancer Project, St Mary's Hospital , Praed Street, London W2 1NY,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J S","family":"Fry","sequence":"additional","affiliation":[{"name":"The Large Bowel Cancer Project, St Mary's Hospital , Praed Street, London W2 1NY,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L P","family":"Fielding","sequence":"additional","affiliation":[{"name":"The Large Bowel Cancer Project, St Mary's Hospital , Praed Street, London W2 1NY,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[1985,4,1]]},"reference":[{"key":"2024092717125624100_bib1","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1002\/bjs.18004519109","article-title":"The treatment of acute obstruction or perforation with carcinoma of the colon and rectum","volume":"45","author":"Goligher","year":"1957","journal-title":"Br J Surg"},{"key":"2024092717125624100_bib2","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1097\/00000658-196705000-00008","article-title":"Obstruction in carcinoma of the colon","volume":"165","author":"Floyd","year":"1967","journal-title":"Ann Surg"},{"key":"2024092717125624100_bib3","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1001\/archsurg.1972.04180040015003","article-title":"Factors in the prognosis of adenocarcinoma of the colon and rectum","volume":"104","author":"Sanfelippo","year":"1972","journal-title":"Arch Surg"},{"key":"2024092717125624100_bib4","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1002\/bjs.1800610105","article-title":"Survival after primary and after staged resection for large bowel obstruction caused by cancer","volume":"61","author":"Fielding","year":"1974","journal-title":"Br J Surg"},{"key":"2024092717125624100_bib5","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1016\/0002-9610(74)90302-X","article-title":"Management of severe obstruction of the large bowel due to malignant disease","volume":"127","author":"Welch","year":"1974","journal-title":"Am J Surg"},{"key":"2024092717125624100_bib6","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1002\/bjs.1800641015","article-title":"The treatment of colonic cancer presenting with intestinal obstruction","volume":"64","author":"Irvin","year":"1977","journal-title":"Br J Surg"},{"key":"2024092717125624100_bib7","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1007\/BF02555634","article-title":"Survival in acute obstructing colorectal carcinoma","volume":"27","author":"Umpleby","year":"1984","journal-title":"Dis Colon Rectum"},{"key":"2024092717125624100_bib8","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1016\/S0140-6736(78)92660-0","article-title":"Surgeon related variables and the clinical trial","volume":"ii","author":"Fielding","year":"1978","journal-title":"Lancet"},{"key":"2024092717125624100_bib9","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1136\/bmj.281.6237.411","article-title":"Anastomotic integrity after operations for large bowel cancer: a multi-centre study","volume":"281","author":"Fielding","year":"1980","journal-title":"Br Med J"},{"key":"2024092717125624100_bib10","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1136\/bmj.281.6237.411","article-title":"Large bowel obstruction caused by cancer: a prospective study","volume":"281","author":"Fielding","year":"1980","journal-title":"Br Med J"},{"key":"2024092717125624100_bib11","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1136\/jcp.34.5.509","article-title":"Histopathology reporting in large bowel cancer","volume":"34","author":"Blenkinsopp","year":"1981","journal-title":"J Clin Pathol"},{"key":"2024092717125624100_bib12","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1002\/bjs.1800710104","article-title":"Local recurrence following \u2018curative\u2019 surgery for large bowel cancer. 1. 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