title: [Subtotal or total colectomy as surgical treatment of left-sided occlusive colon cancer].
abstract: BACKGROUND
  The treatment of acutely obstructed carcinoma of the left colon and sigmoid still represents a matter of controversy. The aim of this study was to assess retrospectively the results of its management by emergency subtotal or total colectomy with primary anastomosis.
  
  
  RESULTS
  Sixty-seven patients were reviewed. There were 42 males and 25 females. The mean age was 70.5 years (range: 26-87 years). Mean operative time was 210 minutes. There were five synchronous colon carcinomas (7.5%) and 23 (343%) synchronous tubulous and tubulo-villous adenomas. No death was noted in the series. Ten postoperative complications (15%) occurred in nine patients including one postoperative peritonitis without evidence of anastomotic leak, one alithiasic cholecystitis, one evisceration and two intra-abdominal abscesses. The mean hospital stay was 11.4 days. Fifty-eight patients were assessed at three and twelve months for functional results. No fecal incontinence was encountered. The mean number of bowel movements per 24 hours was 3.2 at three months and 2 at twelve months. All patients were satisfied with their quality of life. Twelve patients (20.7%) occasionally needed anti-diarrheic medications.
  
  
  CONCLUSIONS
  Urgent subtotal or total colectomy with primary anastomosis is a safe and efficient procedure in the management of acutely obstructed neoplasm of the left colon. It allows to treat in one stage the cancer and the obstruction, bearing no mortality, acceptable morbidity and satisfactory postoperative functional results.
authors.affiliation: Service de Chirurgie générale, Hôtel-Dieu de France, Beyrouth, Liban. ctohme.hdf@usj.edu.lb
authors.forename: Cyril
authors.initials: C
authors.lastname: Tohmé
authors.forename: Ghassan
authors.initials: G
authors.lastname: Chakhtoura
authors.forename: Bassam
authors.initials: B
authors.lastname: Abboud
authors.forename: Roger
authors.initials: R
authors.lastname: Noun
authors.forename: Riad
authors.initials: R
authors.lastname: Sarkis
authors.forename: Henri
authors.initials: H
authors.lastname: Ingea
authors.forename: Pierre
authors.initials: P
authors.lastname: Farah
authors.forename: Antoine
authors.initials: A
authors.lastname: Ghossain
mesh_terms: D000236:Adenoma / Q000150:complications* / Q000601:surgery*; D018253:Adenoma, Villous / Q000150:complications* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000150:complications* / Q000601:surgery*; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000150:complications* / Q000601:surgery*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D012811:Sigmoid Neoplasms / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome