[Surgical-treatment of Obstructing Carcinoma of the Left Colon]
(1991) Acta Chirurgica Belgica (Bilingual Edition) — n° 1, p. 1-10 (1991)
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- Abstract
- From 1977 to 1989, 66 patients were operated on in emergency, without any bowel preparation, for acutely obstructing left-sided colon cancer. Two synchronous cancers were diagnosed and the 68 tumours were located as follows: 13 on the left transverse colon or at the splenic flexure, 7 on the descending colon, 37 on the sigmoid, and 11 at the rectosigmoid junction or below. According to Astler-Coller staging, 15 patients were classified as B, 17 as C and 25 as D. Initial treatment was a colostomy in 58 patients (88%), or a resection with or without anastomosis in 2 and 6 cases respectively. Most patients underwent a two- or more rarely a three-staged resection and 44 patients left the hospital without either tumour or stomy. Cumulative operative mortality was 12%. Five-year survival rates were 21% for the patients with a minimal potential follow-up of 5 years, and 39% for curative resections (disease-free survival of 33%). From these results, we think that two-staged resection, with close proximal colostomy followed by resection and anastomosis, remains an appropriate approach for most obstructing left-sided colon cancers; more tempting procedures such as resection with primary anastomosis or subtotal colectomy are probably indicated in selected patients.
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Jamart, J., Detry, R., Vandenabeele, M., & Kestens, PJ. (1991). [Surgical-treatment of Obstructing Carcinoma of the Left Colon]. Acta Chirurgica Belgica (Bilingual Edition), 1, 1-10. https://hdl.handle.net/2078.5/68908 (Original work published 1991)