title: Is total-subtotal colectomy and primary anastomosis a good treatment alternative in malignant obstructive lesions of the left colon?
abstract: BACKGROUND
  This study was designed in order to compare the effectiveness of subtotal-total colectomy with other surgical methods in the treatment of malignant obstructive lesions of the left colon.
  
  
  METHODS
  Patients admitting with symptoms of colonic obstruction and treated by emergency surgery in Konya Education and Research Hospital between 2004 and 2007 were enrolled. Patients were divided into three groups according to the surgical procedures (Group I: Hartmann procedure; Group II: resection + diverting ileostomy; Group III: total-subtotal colectomy). Related patient data were evaluated retrospectively.
  
  
  RESULTS
  The mean age of 62 patients was 64 (38-89) years. There were no significant differences between the groups with respect to gender, age, American Society of Anesthesiology scores, and tumor stages. There were no significant differences between the study groups in terms of operative duration, postoperative mortality, and five-year survival; however, the length of hospital stay and hospitalization costs were lower in Group III compared to the other groups.
  
  
  CONCLUSIONS
  We suggest that subtotal-total colectomy performed by experienced surgeons may be a good alternative to the other procedures.
authors.affiliation: Department of General Surgery, Konya Training and Research Hospital, Konya, Turkey. arslanka74@hotmail.com
authors.forename: Kemal
authors.initials: K
authors.lastname: Arslan
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Eryılmaz
authors.forename: Ahmet
authors.initials: A
authors.lastname: Okuş
authors.forename: Osman
authors.initials: O
authors.lastname: Doğru
authors.forename: Omer
authors.initials: O
authors.lastname: Karahan
authors.forename: Hande
authors.initials: H
authors.lastname: Köksal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000191:economics; D003082:Colectomy / Q000191:economics; D003106:Colon / Q000601:surgery*; D003110:Colonic Neoplasms / Q000150:complications* / Q000191:economics / Q000601:surgery; D004630:Emergencies; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007081:Ileostomy / Q000191:economics; D007415:Intestinal Obstruction / Q000191:economics / Q000209:etiology / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies