The surgical treatment of intestinal obstruction due to left sided carcinoma of the colon.
Forty two consecutive patients who underwent surgery for an obstructing carcinoma of the left colon over a 5 year period were studied retrospectively. Twelve patients underwent an initial defunctioning procedure with no hospital deaths but with four deaths after a mean follow-up of 25 months. Of the 30 patients who had a primary tumour resection, 7 died during the first hospital admission and a further 4 during a mean follow-up period of 23.7 months. The hospital mortality following primary resection was related to the site and timing of the anastomosis. During the first hospital admission 3 of 5 patients died after colocolic anastomosis, 3 of 10 died following ileocolic anastomosis, but only 1 of 15 died in those who did not have a primary anastomosis performed. The mean hospital stay of patients undergoing a delayed resection was 41 (s.e. (mean) 2.8) days compared to 24 (s.e. (mean) 2.8) days in those undergoing a primary resection. Primary tumour resection with a delayed anastomosis is recommended on the basis of these findings.
Huddy
S P
SP
Royal Surrey County Hospital, Guildford.
Shorthouse
A J
AJ
Marks
C G
CG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D003110:Colonic Neoplasms / Q000150:complications* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012086:Reoperation