การรักษามะเร็งลำไส้ใหญ่ด้านซ้ายอุดตันเฉียบพลันด้วยการผ่าตัด Subtotal Colectomy แล้วเย็บต่อลำไส้ทันที

บทคัดย่อ

Objective : To assess results and complications of emergency subtotal colectomy with ileo-rectal anastomosis in patients presented with acute obstructed left-sided colonic cancer without preoperative bowel preparation.

Design : Retrospective study

Setting : Department of surgery, Nakhonpathom hospital

Subjects : 24 cases of acute obstructed left-sided colonic cancer without perforation.

Intervention : Emergency subtotal colectomy with immediate ileo-rectal anastomosis

Outcome measures : Mortality, morbidity, hospital stay, frequency of defecation

Results : No peri-operative mortality. Morbidity after subtotal colectomy was 4.2%. Only minor wound infection was found. No anastomotic leakage. No intra-peritoneal collection. Mean hospital stay was 11 days (range 7-30). Mean frequency of defecation on discharge from hospital was 5 times/24 hrs (range 1-10).

Conclusions : Subtotal colectomy with ileo-rectal anastomosis is appropriate for treating acute obstructed left-sided colonic cancer when preoperative bowel preparation can not be done provided that a skilled surgeon is available.