| Title: |
Subtotal Colectomy is a Safe, Effective, and Well-tolerated Single-stage Treatment for Acute Left Colonic Malignant Obstruction |
| Authors: |
Senthil Kumar Ganapathi; Harish Kakkilaya; Sathiyamoorthy Rudramurthy; Rajapandian Subbiah; Aravinth Subramanium; Praveen Raj; Palanivelu Chinnusamy |
| Source: |
Indian Journal of Colo-Rectal Surgery, Vol 7, Iss 1, Pp 3-8 (2024) |
| Publisher Information: |
Wolters Kluwer Medknow Publications |
| Publication Year: |
2024 |
| Collection: |
Directory of Open Access Journals: DOAJ Articles |
| Subject Terms: |
acute colonic obstruction; left colon cancer; single-stage surgery; subtotal colectomy; Surgery; RD1-811 |
| Description: |
Purpose: Primary resection and anastomosis for malignant acute obstruction of the left colon offers a single-stage surgical option without a stoma. Our aim was to determine the outcome of subtotal colectomy in acutely obstructed left colonic cancer. Methods: A retrospective review of all patients who underwent subtotal colectomy for acutely obstructed left colon cancer over 10 years was performed. All procedures were performed by specialist colorectal surgeons. The primary objective was to analyze the anastomotic leak rate and the functional outcome measured in terms of frequency of bowel movements. Results: A total of 72 patients underwent subtotal colectomy, among which one patient had primary peritoneal carcinomatosis causing obstruction of the sigmoid colon. Male predominance was noted (61.1%). The tumors predominantly involved the distal transverse colon (23/71) and proximal sigmoid colon (22/71), followed by the descending colon (16/71) and splenic flexure (11/71). All the patients had locally advanced T3 and T4 tumors leading to colonic obstruction. Eight patients had synchronous adenomatous polyps, among which three of them had high-grade dysplasia. Seven patients had synchronous nonobstructing malignant colonic lesions. The average postoperative stay in the hospital was 6.5 days. Only one patient had an anastomotic leak (1.4%). The average frequency of bowel movements per day was 2.83 at 6 months after surgery. There was no mortality during the 6-month follow-up. Conclusion: Subtotal colectomy is a safe, effective, and well-tolerated single-stage procedure with acceptable functional outcome with the added benefits of removing synchronous polyps and cancers. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
https://journals.lww.com/10.4103/ijcs.ijcs_9_23; https://doaj.org/toc/2666-0784; https://doaj.org/toc/2666-0792; https://doaj.org/article/a14b95be67c74dc88a95423f2f7587f4 |
| DOI: |
10.4103/ijcs.ijcs_9_23 |
| Availability: |
https://doi.org/10.4103/ijcs.ijcs_9_23; https://doaj.org/article/a14b95be67c74dc88a95423f2f7587f4 |
| Accession Number: |
edsbas.9DA6FD36 |
| Database: |
BASE |