Primary resection and anastomosis in obstructed descending colon due to cancer
S. G. Tan, R. Nambiar, A. Rauff, S. S. Ngoi and H. S. Goh
Department of Surgery, Singapore General Hospital.
Intraoperative colonic irrigation followed by one-stage resection is
gaining popularity as the optimal surgical treatment for left-sided colonic
obstruction. However, its efficacy and potential hazards have not been
adequately tested in obstruction due to colonic cancer. We analyzed the
early results of 23 consecutive patients with obstructive left-sided
colonic carcinoma treated by primary resection and anastomosis following
intraoperative antegrade colonic lavage. Two patients (8.6%) died, one from
complication of anastomotic leakage. The significant postoperative
complications were chest infection in three (13%) and wound infection in
seven (30.4%). The average hospital stay was 16.5 days. The results of this
study suggest that intraoperative bowel irrigation permits one-stage
resection and anastomosis to be conducted with reasonable safety provided
care is taken in operative techniques.
