Laparoscopy and colonoscopy for left-sided colonic carcinoma with acute bowel obstruction / 中华普通外科杂志

ABSTRACT

Objective To evaluate the effect of via-anal preoperative depression with assistance of colonoscopy and primary stage laparoscopic cancer resection and anastomosis for the treatment of malignant obstruction of left-sided colon. Methods Eleven cases of malignant left-sided colonic obstruction were treated from December 2004 to August 2007 by this modality.With the help of colonoseopy and the guiding of radiography,ileus tube was inserted into the proximal bowel of the obstructive site via anus.We used the tubes to decompress the dilated bowel.Patient's symptom,bowel sounds,abdominal girth,intra-abdominal pressure,plain abdominal radiograph were observed.After the relief of bowel obstruction,elective laparoseopic colorectal resection and anastomosis was accomplished in one stage with routine preoperative preparation.Results After 5～14 days of depression by ileus tube,the relief of bowel obstruction was achieved in all these patients hence emergency operation wag avoided.Elective first-staged laparoseopic resection and anastomosis was performed in all 11 cases.The complications such as anastomotic leakage and incisional/abdominal cavity infection were not observed.After an average 15.2-month fouow up,local recurrence rate,incisional or port implantation rate,and tunlor-free survival rate were 9%,0 and 91% respectively. Conclusions First-staged laparoscopic resection and anastomosis assisted by preoperative colonoscopic depression in malignant left-sided colonic obstruction is a safe and effective procedure.