Surgical treatment strategies for left colon carcinoma with obstruction / 中国实用外科杂志

ABSTRACT

Left colon carcinoma with obstruction is a tough problem for the department of colorectal surgery to tackle with.It has specific clinical characters and various surgical patterns. Surgical strategies are still in great debate.Conventional three-staged operation and Hartmann operation still have a little value for clinical application. Colonic lavage during the operation combined with one-staged operation can be an important choice for emergency surgeries. As the popularization of colonic stent,selective operation after the insertion of colonic stent is considered to be safe and available. Selective laparoscopic surgery after colonic stent insertion accelerates the rehabilitation of patients and advances their quality of life,which correlates with the theories of minimally invasive surgery and accelerated rehabilitation. However,surgeons are supposed to pay more attention to perforation and relocation caused by colonic stent which may make tumor spread and increase the risk of recurrence. In order to reduce patients' trauma and increase their quality of life as well as long-term prognosis,surgeons need to pursue assistance from multi-disciplinary treatment(MDT) and accomplish an individualized treating project according to patients' condition.