[Comparison between primary anastomosis after intraoperative colonic defecation and Hartmann procedure in patients with obstructive left colon cancer].
OBJECTIVE
To compare primary anastomosis after intraoperative colonic defecation and Hartmann procedure for obstructive left colon cancer.


METHODS
Clinical data of 68 patients who underwent emergent laparotomy for left colon cancer with acute bowel obstruction between January 2000 and January 2008 were analyzed retrospectively.


RESULTS
Primary resection and anastomosis with intraoperative defecation was performed in 43 patients and Hartmann's procedure in 25 cases. Patients in both groups were comparable in terms of age, gender, nutritional status, underlying diseases, tumor location and stage, etc. The morbidity and mortality in the two groups were 25.6% vs 28.0% (P=0.761) and 2.3% vs 4.0% (P=0.369), respectively, and the differences were not statistically significant. The length of hospital stay (including first resection operation and second admission for colostomy closure) was (16.6+/-7.8) d in the primary anastomosis group and (24.6+/-9.4) d in the Hartmann procedure group, and the difference was statistically significant (P=0.002). The costs of hospitalization in the two groups were CNY 50,192.8+/-39,727.4 and CNY 58,382.1+/-30,304.9 (P=0.020).


CONCLUSIONS
Primary resection with intraoperative colonic defecation is safe and effective, and should be considered as an alternative to Hartmann procedure for obstructive left colon cancer in selected patients.
Wang
Ya-Jun
YJ
Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China. puwaiyajun@yahoo.cn
Li
Fei
F
Fang
Yu
Y
Li
Ang
A
Liu
Dong-Bin
DB
Sun
Jia-Bang
JB
D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods*; D003082:Colectomy / Q000379:methods*; D003106:Colon / Q000601:surgery; D003110:Colonic Neoplasms / Q000601:surgery*; D003672:Defecation; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative; D012189:Retrospective Studies