Subtotal colectomy with antiperistaltic cecoproctostomy is an alternative technique for two-stage management of obstructed left colon carcinoma  

作　　者：JIANG Cong-qing QIAN Qun WU Yun-hua ZHANG Ya-jie ZHENG Ke-yan LIU Zhi-su 

机构地区：[1]Department of Colorectal Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China

出　　处：《Chinese Medical Journal》2010年第24期3722-3724,共3页中华医学杂志（英文版）

摘　　要：Left colon carcinoma presented with obstruction is a frequently encountered emergency. The surgical treatment of acutely obstructed left colon carcinoma （OLCC） still remains controversial because of its high associated morbidity and mortality, and the number of different surgical options available. Despite current trends toward emergency colectomy with primary anastomosis or colonic stenting as a bridge to subsequent elective surgery, the left hemicolectomy with temporary terminal colostomy remains a choice. Some of these patients who have received temporary colostomies are candidates for restoration of intestinal continuity when patient＇s medical conditions are optimized. The conventional open approach for the closure of left sided colostomies carries a significant morbidity with leakage rates ranging from 0 to 15% and an operative mortality reported as high as 10%. In fact, some patients with colostomies have significant intra-abdominal adhesions,which may result in difficulties in adequate mobilization of hepatic flexure and transverse colon and flawless anastomotic construction. Here we propose an alternative technique for the management of OLCC： subtotal colectomy with antiperistaltic cecoproctostomy.Left colon carcinoma presented with obstruction is a frequently encountered emergency. The surgical treatment of acutely obstructed left colon carcinoma （OLCC） still remains controversial because of its high associated morbidity and mortality, and the number of different surgical options available. Despite current trends toward emergency colectomy with primary anastomosis or colonic stenting as a bridge to subsequent elective surgery, the left hemicolectomy with temporary terminal colostomy remains a choice. Some of these patients who have received temporary colostomies are candidates for restoration of intestinal continuity when patient＇s medical conditions are optimized. The conventional open approach for the closure of left sided colostomies carries a significant morbidity with leakage rates ranging from 0 to 15% and an operative mortality reported as high as 10%. In fact, some patients with colostomies have significant intra-abdominal adhesions,which may result in difficulties in adequate mobilization of hepatic flexure and transverse colon and flawless anastomotic construction. Here we propose an alternative technique for the management of OLCC： subtotal colectomy with antiperistaltic cecoproctostomy.

关 键 词：colon carcinoma intestinal obstruction COLECTOMY cecoproctostomy 

分 类 号：S836[农业科学—畜牧学] TM732[农业科学—畜牧兽医]