One-stage subtotal colectomy with anastomosis for obstructing carcinoma of the left colon

Abstract

Fourteen cases of severe obstructing carcinoma of the left colon were treated by emergency subtotal colectomy and ileorectal or ileosigmoid anastomoses. There was 1 death after 2 mo. and 2 further septic postoperative complications. Follow-up stretched from 2-39 mo. (an average 13.7 mo.). One patient died of a myocardial infarction after 11 mo. and another of liver metastases after 21 mo. Two patients were lost to follow-up at 12 and 25 mo.; 9 patients remain alive and well, free of disease. The last 9 cases were consecutive; 2 additional patients with obstruction had only colostomy performed due to their poor conditions. A staged approach to treatment reduces long-term survival and induces a high cumulative mortality and morbidity rate; colostomy also reduces the quality of life for the elderly patient. Results of this form of treatment [subtotal colectomy with anastomosis] are surprisingly good; it is advocated as the treatment of choice for the vast majority of patients.