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KMID : 0356720050210040207
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Journal of the Korean Society of Coloproctology
2005 Volume.21 No. 4 p.207 ~ p.212
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Safety of a One-stage Operation for an Obstructed Left Colon Carcinoma
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Oh Soo-Yoon
Ahn Eun-Jung
Chung Soon-Sup
Lee Ryung-Ah
Kim Kwang-Ho
Park Eung-Bum
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Abstract
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Purpose: For a left-sided colonic obstruction, the traditional method of a staged defunctioning colostomy and resection has been performed. Recently, there has been a trend towards a one-stage primary resection and anastomosis. The aim of this study was to assess the safety and the efficacy of a one-stage resection and anastomosis for obstructed left colon cancer.
Methods: We retrospectively reviewed the records of 29 patients who had been diagnosed as having an obstructed left-sided colon cancer during the period from January 1995 to December 2003 at Ewha Womans University Hospital. We compared two techniques, a one-stage operation (10 cases) and a staged operation (13 cases).
Results: The mean age of the one-stage group was 58.5±16.1, and that of the staged operation group was 65.0±13.4. Both groups had similar co-morbidities, TNM stages, and tumor locations. In the one-stage operation group, a subtotal colectomy (n=3), a resection and anastomosis with intraoperative lavage (n=5), and a resection and anastomosis following stent insertion (n=2) had been performed. Patients who had undergone a colostomy as the first operation, resection and anastomosis (n=3), and a resection and anastomosis following a defunctioning colostomy (n=10) were included in the staged operation group. The mean postoperative hospital stay showed no significant differences between the two groups. One patient who had undergone a one-stage operation presented with an intestinal partial obstruction five months later. There were no anastomotic leakages, intraabdominal absceses, and wound infections, nor were there any mortalities.
Conclusions: A one-stage resection and primary anastomosis for obstructed left-sided colon cancer can be done safely without significant morbidity. J Korean Soc Coloproctol 2005;21:207-212
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KEYWORD
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Obstructing colon cancer, One-stage operation, Staged operation
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