OBSTRUCTING LEFT COLONIC CARCINOMA: THE SURGICAL CHALLENGE | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 32, Issue 4, October 2013, Page 266-273 PDF (84.31 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejsur.2013.366720 | ||||
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| Authors | ||||
Wael E. Lotfy   ; Yaser Husein; Mohamed G. Negm
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| Department of General Surgery and Psychiatry, Faculty of Medicine, Zagazig University, Egypt | ||||
| Abstract | ||||
| Aim: To approach the best surgical procedure to manage obstructing carcinoma of the left colon. Methods: A total of 75 patients with obstructing left colonic carcinoma were equally randomized into three groups, 25 patients each. Group I underwent Hartmann's procedure, group II underwent primary resection anastomosis with covering ileostomy, while group III underwent primary resection anastomosis after on-table colonic lavage. The results of the three procedures were recorded and compared regarding the operative time, operative blood loss, the post-operative morbidity and mortality, intestinal leakage, psychological drawbacks, the hospital stay and the delay in starting the course of chemotherapy. Results: There was no significant difference in the incidence of postoperative morbidity and mortality among the three groups but there is highly significant decrease in the incidence of nutritional deficiencies & psychological troubles and in the total hospital stay and time delay before receiving the chemotherapy in group III in comparison to group I & II. There was similar risk of anastomotic leakage in the three groups Conclusion: Primary resection anastomosis after on-table colonic lavage appears to be the most ideal procedure as it provides a single stage final solution of the problem without increased risk of leakage or other complications and with the least psychological impact on the patient. | ||||
| Keywords | ||||
| Intestinal obstruction; colonic carcinoma; on-table lavage | ||||
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