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KMID : 0356720010170030148
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Journal of the Korean Society of Coloproctology
2001 Volume.17 No. 3 p.148 ~ p.152
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Surgical Treatment for Obstructing Carcinomas of the Left Colon and Rectum
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Kim Jung-Soo
Park Sang-Su
Yoon Jin
Kim Il-Myung
Yang Dae-Hyun
Yoo Byung-Wook
Cho Ik-Hang
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Abstract
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Purpose: There have been many different kinds of operations for obstructing left colon (distal to splenic flexure) cancer and rectal cancer because immediate resection and anastomosis was known to cause many complications. We performed this study to analyse operative cases and evaluate which procedure had the better result.
Methods: Thirty-six cases of left colon cancer and rectal cancer with complete obstruction were analysed from April 1990 to January 2001 and those cases were divided into two groups, the group of staged procedure and the group of primary resection. 28 cases were curative operations and 8 cases were palliative operations.
Results: The group of staged procedures had 17 cases of curative operations with 1st. stage-colostomy and 2nd. stage-cancer resection. And the group of primary resection had 11 cases of curative operations, 6 cases of Hartmann’s procedures, 2 cases with intraoperative colonic lavage and resection and 3 cases with cancer resection, anastomosis and proximal colostomy. There were no differences in the distribution of age and cancer stage between two groups. In both groups, the sigmoid colon was the most prevalent obstruction site. The staged procedure group had higher operative mortality (25%) than the primary resection group (8%). And 5-year survival rate of the primary resection group was higher than that of the staged procedure group (45%: 33%), but there was no statistical significance.
Conclusion: We think that the primary resection is the better surgical procedure because of shorter hospital stay and fewer operations in the treatment of obstructing left colon and rectal cancer.
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KEYWORD
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Left colon cancer, Obstruction, Primary resection
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