title: Reviewing the Management of Obstructive Left Colon Cancer: Assessing the Feasibility of the One-stage Resection and Anastomosis After Intraoperative Colonic Irrigation.
abstract: The management of obstructive left colon cancer (OLCC) remains debatable with the single-stage procedure of primary colonic anastomosis after cancer resection and on-table intracolonic lavage now being supported.
  
  
  
  Patients with acute OLCC who were admitted between January 2008 and January 2015 were distributed into 5 different groups. Group ICI underwent emergency laparotomy for primary anastomosis following colonic resection and intraoperative colonic lavage; Group HP underwent emergency Hartmann's Procedure; Group CON consisted of patients treated by conservative management with subsequent elective open cancer resection; Group COL were colostomy patients; and Group INT consisted of patients who had interventional radiology followed by open elective colon cancer resection. The demographics of the patients and comorbidity, intraoperative data, and postoperative data were collected, with P < .05 as significant.
  
  
  
  There were 4 deaths in 138 cases (2.90%). There was only 1 patient who had anastomotic leakage (5.56%) in Group ICI, compared with none in Group HP and Group COL, 1 case in Group INT (7.69%), and 2 cases in Group CON (6.06%) (P > .05). Group INT and Group CON, when compared to the three surgical groups, Groups ICI, Group COL, and Group HP, individually, were statistically significant for the duration of surgery (P < .05).
  
  
  
  Primary anastomosis following colonic resection after irrigation can be safely performed in selected patients, with the necessary surgical expertise, with no increased risk in mortality, anastomotic leakage, and other postoperative complications.
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.
authors.forename: Gavish Kumar
authors.initials: GK
authors.lastname: Awotar
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.
authors.forename: Guoxin
authors.initials: G
authors.lastname: Guan
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.
authors.forename: Wei
authors.initials: W
authors.lastname: Sun
authors.affiliation: Department of General Surgery, The Third Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.
authors.forename: Hongliang
authors.initials: H
authors.lastname: Yu
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.
authors.forename: Ming
authors.initials: M
authors.lastname: Zhu
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.
authors.forename: Xinye
authors.initials: X
authors.lastname: Cui
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.
authors.forename: Jie
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.
authors.forename: Jiaxi
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.
authors.forename: Baoshun
authors.initials: B
authors.lastname: Yang
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.
authors.forename: Jianyu
authors.initials: J
authors.lastname: Lin
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.
authors.forename: Zeyong
authors.initials: Z
authors.lastname: Deng
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.
authors.forename: Jianwei
authors.initials: J
authors.lastname: Luo
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.
authors.forename: Chen
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.
authors.forename: Osman Abdifatah
authors.initials: OA
authors.lastname: Nur
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Dhiman
authors.affiliation: Institute of Cancer Stem Cell & College of Pharmacy, Dalian Medical University, Dalian, China.
authors.forename: Pixu
authors.initials: P
authors.lastname: Liu
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China. Electronic address: fuwenluo@aliyun.com.
authors.forename: Fuwen
authors.initials: F
authors.lastname: Luo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods*; D057868:Anastomotic Leak / Q000453:epidemiology; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000601:surgery*; D003125:Colostomy / Q000379:methods; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000601:surgery; D007430:Intraoperative Care / Q000379:methods; D007813:Laparotomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D007507:Therapeutic Irrigation / Q000379:methods*
keywords: Colonic lavage; Hartmann's procedure; Segmental colectomy; Self-expanding metallic stenting; Trans-anal drainage tube