Subtotal colectomy with primary anastomosis without diversion in the treatment of obstructing carcinoma of the left colon

Klatt, Gordon R.; Martin, William H.; Gillespie, James T.

doi:10.1016/0002-9610(81)90053-2

Cited by 52 publications

(12 citation statements)

References 4 publications

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“…[14] It has been reported in several studies that single-step procedures are more advantageous compared with multi-step procedures in the surgical management of obstructive malignancies of the left colon in terms of short-and long-term survival. [10,11,[15][16][17] This study was designed in order to compare the effectiveness of emergent subtotal-total colectomy and primary anastomosis with other surgical methods in the treatment of malignant obstructive lesions of the left colon. Demographic characteristics, comorbidities, colonic obstruction level, surgical procedures, operative duration, length of hospital stay, postoperative morbidity and mortality, and five-year survival rates were evaluated.…”

Section: Resultsmentioning

confidence: 99%

“…[20][21][22][23][24] The need for stoma, which is often left open due to lack of opportunity for closure, is eliminated in these single-step procedures, which are also associated with lower mortality and morbidity rates. [10,11,[15][16][17] This study was designed in order to compare the effectiveness of emergent subtotaltotal colectomy and primary anastomosis with other surgical methods in the emergent treatment of malignant obstructive lesions of the left colon.…”

Section: Resultsmentioning

confidence: 99%

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Is Total-subtotal Colectomy and Primary Anastomosis Good Treatment Alternatives in Malignant Obstructive Lesions of the Left Colon?

Arslan¹,

Eryılmaz²,

Okuş³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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AMAÇBu çalışmada, sol kolonun tıkayıcı malign lezyonlarında total-subtotal kolektomi anostomoz ile diğer cerrahi tedavi yöntemleri karşılaştırıldı. GEREÇ VE YÖNTEMÇalışmaya Konya Eğitim ve Araştırma Hastanesine 2004-2007 yılları arasında transvers kolon distalinde tıkanıklık bulguları ile başvuran ve cerrahi tedavi uygulanan hastalar dahil edildi. Hastalar cerrahi prosedüre göre üç gruba ayrıl-dı. Bunlar: Grup I: Hartmann prosedürü; Grup II: Rezeksiyon, anostomoz ve saptırıcı ileostomi; Grup III: Total veya subtotal kolektomi ve primer anastomoz. Hastaların dosyaları geriye dönük olarak incelendi. BULGULARAltmış iki hastanın yaş ortalaması 64 (dağılım, 38-89 yaş) idi. Birinci grupta 15, ikinci grupta 21, üçüncü grupta 26 hasta vardı. Gruplar arasında yaş ortalamaları, cinsiyet, ASA skoru ve tümör evresi bakımından anlamlı fark yoktu. Çalışma grupları arasında ameliyat süresi ve ameliyat sonrası morbidite, mortalite ve beş yıllık sağkalım açısından anlamlı fark yoktu, ancak hastanede kalma süresi ve tedavi maliyetleri açısından Grup I ve Grup II'ye göre Grup III'de anlamlı olarak düşüktü. SONUÇDeneyimli cerrahlar tarafından yapılan total-subtotal kolektomi ve primer anostomozun diğer bir veya iki aşmalı cerrahi prosedürlere göre daha iyi bir alternatiftir.Anahtar Sözcükler: Sol kolon tıkayıcı tümörlerinin tedavisi, total veya subtotal kolektomi; Hartmann prosedürü; rezeksiyon; saptı-rıcı ileostomi.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Is Total-subtotal Colectomy and Primary Anastomosis Good Treatment Alternatives in Malignant Obstructive Lesions of the Left Colon?

Arslan¹,

Eryılmaz²,

Okuş³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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“…W/ihrend wir eine Anastomoseinsuffizienz und eine massive Anstomosenblutung, die beide letal endeten, zu beklagen hatten, berichten die anderen genannten Autoren [9,12,14,19,20] nach subtotaler bzw. Dabei findet sich eine Mortalit/it von 14,2%, wohingegen die Morbidit/it mit 18,2% nur bedingt aussagef/ihig ist, da in einigen Arbeiten Angaben fiber die Morbidit/it fehlen.…”

Section: Patienten Und Methodeunclassified

“…W/ihrend wir eine Anastomoseinsuffizienz und eine massive Anstomosenblutung, die beide letal endeten, zu beklagen hatten, berichten die anderen genannten Autoren [9,12,14,19,20] nach subtotaler bzw. •hnlich wie Klatt [14] ,,Es erscheint notwendig das Konzept der prim/iren Colektomie sorgf'~iltig und individuell zu/iberlegen. Die meisten Autoren bevorzugen eine ileocolische Anastomose [12,14,19,20], w/ihrend nur wenige Autoren nach subtotaler Colektomie das Restcolon blind verschliel3en und das terminale Ileum als Ileostomie herausleiten [4,21].…”

Section: Patienten Und Methodeunclassified

Neue Aspekte in der operativen Behandlung des Dickdarmileus infolge stenosierenden Coloncarcinoms

Wedell¹,

Banzhaf²,

Eissen³

et al. 1985

Langenbecks Arch Chiv

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Formerly it was considered dangerous to undertake resection in the presence of colonic obstruction. This idea has been abandoned. Immediate right hemicolectomy is the accepted treatment for obstructed lesions of the right colon. For obstruction of the left colon proximal colostomy or caecostomy are being challenged by immediate resection as a Hartmann operation with iliac colostomy or finished with a colo-colonic or colo-rectal anastomosis. A subtotal colectomy with ileo-sigmoid or ileo-rectal anastomosis is a further method with encouraging experiences. From 1979-1984 a series of 33 patients with obstruction from a carcinoma of the left colon underwent emergency abdominal colectomy with primary ileosigmoidostomy or ileorectostomy without diversion. The mortality and morbidity was favourable compared with those reported in series of similar cases treated by stages procedures or primary resection. Several advantages of this method are explained and further encouraging experiences from other centers are reported.

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“…Over the past 10 years, though, a number of authors [11][12][13][14][15][16][17][18] have published encouragingly low opera tive morbidity rates following one-stage, emergency, sub total colectomy, taking advantage, not only of a better healing anastomosis [19], but also of removing in one and same setting the entire length of the fecal-loaded, septic, obstructed colon. These favorable factors would account for low septic complication rates, as opposed to what might be expected from a nonprepared colocolonic or colorectal anastomosis.…”

Section: Introductionmentioning

confidence: 99%

One-Stage Colectomy in the Management of Acutely Obstructed Left Colon Cancer

et al. 1992

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One-stage subtotal colectomy of an acutely obstructed colon would improve quality of life while shortening the length of hospitalization. Prohibitive surgical risks, though, are commonly ascribed to such an approach. Analyzing the senior author’s experience we compared the one-stage approach versus multistaged resection concerning operative mortality and morbidity rates and the duration of hospital stay. Forty-nine out of 291 (17%) large bowel cancer patients presented with acute left-sided obstruction requiring emergency surgery. Colostomy alone was performed in 18 (37%), multistaged colectomy in 20 (41 %, group A) and one-stage subtotal colectomy in 11 (22%, group B), from January 1973 through September 1990. Both groups were comparable regarding age and sex distribution, TNM staging and ASA classification. Operative mortality and morbidity rates were 10 and 30% in group A and 9 and 18% in group B, respectively. The average length of hospital stay was more than twice the number of days in group A. Whenever an experienced surgical team is available and in the absence of contraindications (local factors precluding a swift dissection, hemodynamic instability, gangrenous bowel) a one-stage subtotal colectomy, taking advantage of a better healing ileo-low-sigmoid anastomosis, carries acceptable mortality and morbidity risks while enhancing the quality of life and shortening the length of hospitalization. It should be considered the procedure of choice, provided selection requirements and technical demands are met.

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Subtotal colectomy with primary anastomosis without diversion in the treatment of obstructing carcinoma of the left colon

Cited by 52 publications

References 4 publications

Is Total-subtotal Colectomy and Primary Anastomosis Good Treatment Alternatives in Malignant Obstructive Lesions of the Left Colon?

Is Total-subtotal Colectomy and Primary Anastomosis Good Treatment Alternatives in Malignant Obstructive Lesions of the Left Colon?

Neue Aspekte in der operativen Behandlung des Dickdarmileus infolge stenosierenden Coloncarcinoms

One-Stage Colectomy in the Management of Acutely Obstructed Left Colon Cancer

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