Study of long intestinal tube for decompression of obstructive left colon cancer.
OBJECTIVE
Recently, several reports have recommended primary resection, rather than a staged operation, for obstructive left colon cancer. However pre-operative decompression is important for reducing complications and improving the curability of primary resection. Among the many pre-operative decompression strategies reported, we selected the long intestinal tube and evaluated the effectiveness of this convenient strategy.


METHODS
A long intestinal tube was inserted pre-operatively for decompression in 27 of 29 patients undergoing resection for obstructive left colon cancer (1991-1995). We retrospectively studied the clinical features (responders vs. non-responders) of the 27 patients. We also compared these 27 with 26 other pre-1990 patients, who did not receive pre-operative decompression, in term of post-operative morbidity.


RESULTS
Twelve of the 27 patients were responders; success rate 44.4%. There were no blood profile differences between responders and non-responders, but the time from bowel movement cessation to intestinal tube insertion was 3 days or less in all responders but 4 days or more in non-responders (p<0.001). There was no significant difference in the rate of post-operative morbidity between those with and without pre-operative decompression.


CONCLUSIONS
Decompression is likely to be successful, allowing elective primary resection, when initiated within 3 days of bowel movement cessation. However, more than 4 days post-onset, other decompression methods or emergency surgery is necessary.
Eguchi
T
T
The 3rd Department of Surgery, Nihon University School of Medicine, Japan.
Takahashi
Y
Y
Asai
S
S
Ishii
Y
Y
Fujii
M
M
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000601:surgery*; D007441:Intubation, Gastrointestinal / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011300:Preoperative Care