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The correspondence commends the representativeness of a large multicenter cohort and notes that further clarification is needed regarding post-decompression follow-up conversion therapies, how tumor stage and T3–T4 disease affect treatment selection and anastomotic healing, and the influence of surgical blood supply preservation. It also calls for inclusion of nutritional risk assessment and tailored perioperative nutrition strategies to refine clinical guidance on outcomes and 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is the main focus of the correspondence?","Question",{"text":63,"@type":64},"It comments on the timing of restoration of bowel continuity after decompressing a stoma in left-sided obstructive colon cancer, highlighting strengths and proposing additional analyses.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Why does the author suggest clarifying follow-up treatment after decompression stoma?",{"text":68,"@type":64},"Most patients are described as advanced or locally advanced, and the letter notes that conversion therapies (e.g., neoadjuvant chemotherapy, radiochemotherapy, targeted therapy, immunotherapy) may differently affect anastomotic healing and leakage risk.",{"name":70,"@type":61,"acceptedAnswer":71},"What additional factors does the correspondence recommend including in the study?",{"text":72,"@type":64},"It recommends subgroup analysis regarding preserved blood supply (left colonic artery and superior rectal artery) and adding perioperative nutritional risk 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obstructive colon cancer: a nationwide retrospective cohort’  \nShuai Liu, MM  \nDear Editor,  \nRecently, we read an article by Zamaray et al. [1] on the timing of bowel continuity recovery after decompression stoma in leftsided obstructive colon cancer (LSOCC) . Commendably, this is a nationwide retrospective cohort study with strong representativeness. The large cohort of diverse patient populations from 75 hospitals has enhanced the universality of the study results. This study also builds upon a strong preliminary research foundation, which conducted an in-depth exploration of LSOCC patients[2] . The comprehensive analysis of timing outcomes greatly enriches our understanding of the specificity of LSOCC. However, there are still certain details warranting further exploration.  \nFirstly, most patients with left-sided colon cancer presenting with acute obstructive symptoms are in the advanced or locally advanced stage. The evaluation of tumor (T) staging is often between T3 and T4 . The author fails to elucidate the follow-up treatment for these patients’ post-decompressing stoma. Typically, such patients usually undergo conversion therapies, including neoadjuvant chemotherapy, radiochemotherapy, and, in some cases, targeted therapy and immunotherapy. The impact of these varied conversion therapies on colonic anastomosis healing differs, maybe even related to the risk of anastomotic leakage. After undergoing decompressing stoma to resolve acute obstruction, LSOCC patients need to be evaluated for clinical staging before determining the suitability of conversion therapies in the future. Therefore, the timing study for restoration of bowel continuity (ROBC) holds significant clinical guidance value, especially for LSOCC patients who have undergone conversion therapy.  \nDepartment of Gastrointestinal Surgery, Taizhou Hospital of Zhejiang Province,  \nAffiliated to Wenzhou Medical University, Taizhou, People’s Republic of China Sponsorships or competing interests that maybe relevant to content are disclosed atthe end of this article.  \n*Corresponding author. Address: Department of Gastrointestinal Surgery, Taizhou Hospital of Zhejiang Province, Affiliated to Wenzhou Medical University, Taizhou 317000, People ’s Republic of China. Tel.:+86 0576 8512 0120;  \nfax: +86 0576 8519 0165. E-mail: [lius8913@enzemed.com](lius8913@enzemed.com) (S. Liu).  \nCopyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution-ShareAlike License 4.0, which allows others to remix, tweak, and build upon the work, even for commercial purposes, as long as the author is credited and the new creations are licensed under the identical terms.  \nInternational Journal of Surgery (2024) 110:5835–5836  \nReceived 7 April 2024; Accepted 14 April 2024  \nPublished online 3 May 2024  \n[http://dx.doi.org/10.1097/JS9.0000000000001520](http://dx.doi.org/10.1097/JS9.0000000000001520)  \nSecondly, the surgical approach for left-colon cancer varies depending on the tumor location. Meanwhile, blood supply is an important factor affecting the anastomosis healing of laparoscopic colon cancer surgery[3] . For instance, whether the left colonic artery (LCA) needs to be preserved during surgery in distal sigmoid colon cancer and whether the superior rectal artery (SRA) needs to be preserved during surgery in proximal sigmoid colon cancer. In theory, patients with preserved LCA and SRA during surgery have a more sufficient residual intestinal blood supply, and the risk of anastomotic leakage is lower. Effective preservation of LCA and SRA may reduce the incidence of anastomotic leakage. The above two situations may influence the short-term prognosis and complications after ROBC, requiring a subgroup analysis.  \nThirdly, nutritional risk assessment among LSOCC patients should be incl","cbCaidHx5QaNHvDA","https://ap.wps.com/l/cbCaidHx5QaNHvDA","pdf",200251,"English","# Correspondence\n## Study recognition and overall assessment\n## Follow-up conversion therapies after decompression stoma\n## Surgical approach and blood supply considerations\n## Nutritional risk assessment and perioperative nutrition\n## Closing remarks and publication information","[{\"question\":\"What is the main focus of the correspondence?\",\"answer\":\"It comments on the timing of restoration of bowel continuity after decompressing a stoma in left-sided obstructive colon cancer, highlighting strengths and proposing additional analyses.\"},{\"question\":\"Why does the author suggest clarifying follow-up treatment after decompression stoma?\",\"answer\":\"Most patients are described as advanced or locally advanced, and the letter notes that conversion therapies (e.g., neoadjuvant chemotherapy, radiochemotherapy, targeted therapy, immunotherapy) may differently affect anastomotic healing and leakage risk.\"},{\"question\":\"What additional factors does the correspondence recommend including in the study?\",\"answer\":\"It recommends subgroup analysis regarding preserved blood supply (left colonic artery and superior rectal artery) and adding perioperative nutritional risk assessment with tailored nutritional interventions.\"}]","Correspondence - A commentary on ‘Timing of restoration of bowel continuity after decompressing stoma, in left-sided obstructive colon cancer: a nationwide retrospective cohort’ | PDF",1790016367]