Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Surgical Endoscopy
Published in: Surgical Endoscopy 10/2005

01-10-2005 | Original article

Complete single-stage management of left colon cancer obstruction with a new device

Authors: J.-H. Kim, D.-H. Shon, S.-H. Kang, B.-I. Jang, M.-K. Chung, J.-H. Kim, M.-C. Shim

Published in: Surgical Endoscopy | Issue 10/2005

Login to get access

Abstract

Background

A newly developed device that enables easy intraoperative colonic irrigation and subsequent colonoscopy was introduced recently.

Methods

To evaluate the efficacy of the single-stage procedure with a new device and the significance of on-table colonoscopy, 112 patients with obstructive left colon cancer were recruited.

Results

Primary anastomosis after tumor resection was performed in 104 cases. The volume of saline used for irrigation averaged 13.5 l over 12.1 min. Subsequent colonoscopic examination added an average of 10.4 min to the operative time. There were three anastomotic leaks, two wound infections, four acute renal failures, and two operative mortalities. On-table colonoscopy resulted in extended resection in 17 cases.

Conclusions

The new device enabled safe, simple, and time-saving, single-stage surgical management of left colon cancer obstruction. The ability to perform on-table colonoscopy enabled treatment and recognition of synchronous bowel pathology.
Literature
1.
Arenas RB, Fichera A, Mhoon D, Michelassi F (1997) Incidence and therapeutic implications of synchronous colonic pathology in colorectal adenocarcinoma. Surgery 122: 706–710CrossRefPubMed
2.
Arnaud J-P, Bergamaschi R (1994) Emergency subtotal/total colectomy with anastomosis for acutely obstructed carcinoma of the left colon. Dis Colon Rectum 37: 685–688CrossRefPubMed
3.
Biondo S, Jaunieta E, Jorba R, Moreno P, Farran L, Borobia F, Bettonica C, Poves I, Ramos E, Alcobendas F (1997) Intraoperative colonic lavage and primary anastomosis in peritonitis and obstruction. Br J Surg 84: 222–225CrossRefPubMed
4.
Boley SJ, Agrawal GP, Warren AR, Veith FJ, Levowitz BS, Treiber W, Dougherty J, Schwartz SS, Gliedman ML (1969) Pathophysiologic effects of bowel distention on intestinal blood flow. Am J Surg 117: 228–234CrossRefPubMed
5.
Chiappa A, Zbar A, Biella F, Staudacher C (2000) One-stage resection and primary anastomosis following acute obstruction of the left colon for cancer. Am 66: 619–622
6.
Chu DZJ, Giacco G, Martin RG, Guinee VF (1984) The significance of synchronous carcinoma and polyps in the colon and rectum. Cancer 57: 445–450
7.
Cunliffe WJ, Hasleton PS, Tweedle DE, Schofield PF (1984) Incidence of synchronous and metachronous colorectal carcinoma. Br J Surg 71: 941–943PubMed
8.
Deans GT, Krakowski ZH, Irwin ST (1994) Malignant obstruction of the left colon. Br J Surg 81: 1270–1276PubMed
9.
Deen KI, Madoff RD, Goldberg SM, Rothenberger DA (1998) Surgical management of left colon obstruction: the University of Minnesota experience. J Am Coll Surg 187: 573–576CrossRefPubMed
10.
Dudley HA, Radcliffe AG, McGeehan D (1984) Intraoperative irrigation of the colon to permit primary anastomosis. Br J Surg 67: 80–81
11.
Eguchi K, Yao T, Konomoto T, Hayashi K, Fujishima M, Tsuneyoshi M (2000) Discordance of p53 mutations of synchronous colorectal carcinomas. Mod Pathol 13: 131–139CrossRefPubMed
12.
Forloni B, Reduzzi R, Paludetti A, Colpani L, Cavallari G, Frosali D (1998) Intraoperative colonic lavage in emergency surgical treatment of left-sided colonic obstruction. Dis Colon Rectum 41: 23–27CrossRefPubMed
13.
Gramegna A, Saccomani G (1989) On-table colonic irrigation in the treatment of left-sided large bowel emergencies. Dis Colon Rectum 32: 585–387PubMed
14.
Hardy TG Jr, Aguilar PS, Stewart WR (1989) Complete obstruction of the sigmoid colon treated by primary resection and anastomosis. Dis Colon Rectum 32: 528–532PubMed
15.
Karran SJ, Sutton G, Gartell P, Karran SE, Finnis D, Blenkinsop J (1993) Imipenem prophylaxis in elective colorectal surgery. Br J Surg. 8: 1196–1198
16.
Kim BR, Shon DH, Jang BI, Chung MK, Shim MC, Kim J (2001) The safety of intraoperative colonic irrigation for single-stage procedure in emergency-based left colonic pathology. Korean J Coloproctol 17: 309–315
17.
Krukowski ZH, Matheson NA (1988) Ten-year computerized audit of infection after abdominal surgery. Br J Surg 75: 857–861PubMed
18.
Langevin JM, Nivatvongs S (1984) The true incidence of synchronous cancer of the large bowel: a prospective study. Am J Surg 147: 330–333CrossRefPubMed
19.
Lau PW, Lo CY, Law WL (1995) The role of one-stage surgery in acute left-sided colonic obstruction. Am J Surg 169: 406–409CrossRefPubMed
20.
Lee EC, Murray JJ, Coller JA, Roberts PL, Schoetz DJ (1997) Intraoperative colonic lavage in nonelective surgery for diverticular disease. Dis Colon Rectum 40: 669–674CrossRefPubMed
21.
Mealy K, Salman A, Arthur G (1988) Definitive one-stage emergency large bowel surgery. Br J Surg 75: 1216–1219PubMed
22.
Murray JJ, Schoetz DJ Jr, Coller JA, Roberts PL, Veidenheimer MC (1991) Intraoperative colonic lavage and primary anastomosis in nonelective colon resection. Dis Colon Rectum 34: 527–531PubMed
23.
Nelson IW, Ellis H (1984) The spectrum of intestinal obstruction today. Br J Clin Pract 38: 249–251PubMed
24.
Ohman U (1982) Prognosis in patients with obstructing colorectal carcinoma. Am J Surg 143: 742–774PubMed
25.
Pain J, Cahill J (1991) Surgical options for left-sided large bowel emergencies. Ann R Coll Surg Engl 73: 394–396PubMed
26.
SCOTIA Group (1995) Single-stage treatment for malignant left-sided colonic obstruction: a prospective randomized clinical trial comparing subtotal colectomy with segmental resection following intraoperative irrigation. Br J Surg 82: 1622–1627
27.
Takeuchi H, Toda T, Nagasaki S, Kawano T, Minamisono Y, Maehara Y, Sugimachi K (1997) Synchronous multiple colorectal adenocarcinomas. J Surg Oncol 64: 304–307CrossRefPubMed
28.
Tan SG, Nambiar R, Rauff A, Ngoi SS, Goh HS (1991) Primary resection and anastomosis in obstructed descending colon due to cancer. Arch Surg 126: 748–751PubMed
29.
Torralba JA, Robles R, Parrilla P, Lujan JA, Liron R, Pinero A, Fernandez JA (1998) Subtotal colectomy vs intraoperative colonic irrigation in the management of obstructed left colon carcinoma. Dis Colon Rectum 41: 18–22CrossRefPubMed
30.
Zmora O, Mahajna A, Bar-Zakai B, Rosin D, Hershko D, Shabtai M, Krausz MM, Ayalon A (2003) Colon and rectal surgery without mechanical bowel preparation: a randomized prospective trial. Ann Surg 237: 363–367PubMed
Metadata
Title
Complete single-stage management of left colon cancer obstruction with a new device
Authors
J.-H. Kim
D.-H. Shon
S.-H. Kang
B.-I. Jang
M.-K. Chung
J.-H. Kim
M.-C. Shim
Publication date
01-10-2005
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 10/2005
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-004-8232-3

Other articles of this Issue 10/2005

Surgical Endoscopy 10/2005 Go to the issue

Original Article

Surgical management of intestinal malrotation in adults: comparative results for open and laparoscopic Ladd procedures

Original article

Intraoperative tumor localization using laparoscopic ultrasonography in laparoscopic–assisted gastrectomy

Letter to the Editor

The author replies

Letter

The authors reply

Original article

Laparoscopic distal pancreatectomy with preservation of the spleen and splenic vessels for benign Pancreas neoplasm

Original article

Minimally invasive and local treatment for mucosal early gastric cancer