Document Detail


Management of obstructed left colon carcinoma.
MedLine Citation:
PMID:  17629047     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: The treatment of acutely obstructed carcinoma of the left colon still represents a matter of controversy. The aim of this retrospective study is to review the results of three surgical procedures used in our department of Visceral Surgery (subtotal colectomy, segmental resection following intraoperative irrigation, and Hartman's procedure) and to determine if there were advantages of one technique over the other. METHODOLOGY: Ninety-three patients with acute left colonic obstruction were treated by subtotal/total colectomy (n=38), segmental resection following intraoperative irrigation (n=39), and Hartman's procedure (n=16). We assessed immediate postoperative results (mortality and morbidity rates, reoperation rate and hospital stay. RESULTS: The overall mortality and morbidity rates were respectively 13% (n=12) and 30.1% (n=28). The mortality rate was 13% (n=5) in the subtotal colectomy group, 7.7% (n=3) in the intraoperative colonic irrigation and 25% (n=4) in the Hartman's procedure group. The morbidity rates were similar after subtotal or segmental resection (7.9% vs. 10.2%), bowel movements were more frequent after subtotal colectomy (range 1-5 day) than segmental colectomy (range: 1-2 per day). CONCLUSIONS: Segmental resection following intraoperative irrigation is the preferred treatment for left sided malignant colonic obstruction. Subtotal colectomy is recommended for patients with ischemic lesions and serosal tears on the cecum, and when there is a synchronous neoplasm in the proximal colon.
Authors:
Stéphanie Hennekine-Mucci; Jean Jacques Tuech; Olivier Brehant; Emilie Lermite; Patrick Pessaux; Paul Lada; Antoine Hamy; Jean Pierre Arnaud
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  54     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-07-16     Completed Date:  2007-08-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  1098-101     Citation Subset:  IM    
Affiliation:
CHU-Angers, Department of Visceral Surgery, Angers 49033, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Carcinoma / complications,  mortality,  surgery*
Colectomy / methods*
Colonic Neoplasms / complications,  mortality,  surgery*
Female
Humans
Intestinal Obstruction / etiology,  mortality,  surgery*
Male
Middle Aged
Treatment Outcome

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