Bridge‐to‐surgery in acute right‐sided obstructing colon cancer: A survey of surgeons' perspectives on treatment strategies

AIM: To investigate surgeons' perspectives on the management of right-sided obstructing colon cancer, with particular focus on their views regarding bridge-to-surgery strategies. METHODS: A national cross-sectional descriptive survey study was conducted in the Netherlands between January and October 2024. Questionnaires were distributed among surgeons with an interest in colorectal surgery and surgical trainees specialising in gastrointestinal surgery. RESULTS: Fifty completed questionnaires were analysed; 80% of the respondents were surgeons, 20% were surgical trainees. Emergency resection was reported as the sole treatment option for right-sided obstructing colon cancer in 4% (n = 2), while 64% (n = 32) indicated that emergency resections were performed alongside other treatment strategies. The majority of the respondents preferred a bridge-to-surgery strategy, with bowel decompression with nasogastric tube (38%) and ileostomy (38%) being the most favoured strategies. Endoscopic stenting was not offered in 90%, largely due to the lack of trained endoscopists. CONCLUSION: Management of right-sided obstructing colon cancer varies considerably, though most surgeons and surgical trainees favour bridge-to-surgery approaches. Greater consistency may be achieved through further research and guideline development.