title: Techniques and Outcomes of Endoscopic Decompression Using Transanal Drainage Tube Placement for Acute Left-sided Colorectal Obstruction.
abstract: BACKGROUND
  If it is possible, endoscopic decompression for acute left-sided colorectal obstruction will be effective in critically ill patients. This study was to evaluate the techniques and outcomes of transanal drainage tube placement following urgent colonoscopy in management of acute left-sided colorectal obstruction.
  
  
  METHODS
  From January 2000 to December 2009, 69 consecutive patients (36 males, age 38 to 94, mean = 71) were hospitalized because of acute left-sided colorectal obstruction. Urgent colonoscopy was performed within 12 hours of entry for diagnosis and treatment (mean time, 6.5 hours). Endoscopic decompression using a transanal drainage tube was attempted. Clinical success, methods used, and complications were retrospectively evaluated.
  
  
  RESULTS
  The cause of obstruction was colorectal carcinoma in 66 patients (96%). The site of obstruction was sigmoid colon in 37 (54%), rectum in 20 (29%), and descending colon in 12 (17%). Out of 69 patients, endoscopic decompression using the transanal drainage tube was successful in 66 (96%). The use of combination of transanal drainage tube and the equipped guidewire enabled endoscopic decompression was successful in 45 patients (65%), though a small-diameter upper endoscope was used in 2 patients to introduce the guidewire beyond the obstruction. Perforation during the placement developed in 2 patients and one patient was unsuccessful.
  
  
  CONCLUSIONS
  Transanal drainage tube placement following urgent colonoscopy was effective in the management of acute left-sided colorectal obstruction. In the majority of patients, the materials and methods used for the transanal drainage tube placement were simple and easy.
authors.affiliation: Digestive Disease Center, Showa Inan General Hospital, 3230 Akaho, Komagane, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Ichise
authors.affiliation: Digestive Disease Center, Showa Inan General Hospital, 3230 Akaho, Komagane, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Horiuchi
authors.affiliation: Digestive Disease Center, Showa Inan General Hospital, 3230 Akaho, Komagane, Japan; Department of Pediatrics, Shinshu University School of Medicine, Shinshu University Graduate School of Medicine, Matsumoto, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Nakayama
authors.affiliation: Digestive Disease Center, Showa Inan General Hospital, 3230 Akaho, Komagane, Japan; Department of Metabolic Regulation, Shinshu University Graduate School of Medicine, Matsumoto, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Tanaka
keywords: Colonoscopy; Colorectal obstruction; Transanal drainage tube