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KMID : 0356719960120020285
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Journal of the Korean Society of Coloproctology
1996 Volume.12 No. 2 p.285 ~ p.293
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One-stage Operation in Malignant Obstruction of the Left Colon and Rectum
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Ahn Tae-Wan
Sohn Seung-Kook
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Abstract
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The management of malignant obstruction of the left colon is controversial. The basic principles underlying the previous approaches to management are challenged and more definite one-stage operations are being performed. The purpose being of this’ study is to assess the feasibility and safety of one-stage operation including total/subtotal colectomy, intraoperative colonic lavage. We analysed the early results of 29 consecutive patients with obstructive left-sided colon cancer treated with variable surgical methods at the Yong Dong Severance Hospital between March 1985 and September 1995. The results were as follows: 1) 12 patients underwent one-stage operations(7 cases with subtotal/total colectomy, 2
cases with intraoperative colonic lavage, 3 cases with segmental resection). In this group, the postoperative morbidity was 33.3% including 1 anastomotic leakage(8.3%), 1 anastomotic stenosis and 2 diarrhea, but there was no postoperative death. The average in-hospital stay in this group was 21.3 days. 2) 13 patients underwent staged operations including 8 cases of Hartmanns procedure. In this group, the postroperative morbidity was 38.5% including 1 case of fatal sepsis, 2
significant postopeative bleeding and 4 wound infection. There were one postoperative death as a result of sepsis. The average in-hospital stay in this group was 33.8 days. One-stave operation may be performed safely with improved immediate outcome in selected patients with obstructing carcinoma of the left colon.
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KEYWORD
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Intestinal Obstruction, Subtotal Colectomy
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