[Selection of surgical tactics in colonic obstruction]

From 1989 to 1996, 322 patients with colonic obstruction due to tumors underwent surgery in Surgical clinic No 1 of the Ural National Medical Academy. Specimens of 283 tumors removed at surgery (n = 213) or autopsy (n = 70) were examined in 322 patients. Complications were observed after 144 operations (44.7%); in 82 cases they were fatal (25.5% postoperative mortality). Postmortem examination was performed in 70 cases of 82 (85.37%). Histological examination of the 283 specimens of the resected prestenotic colon wall provided a histological classification of colonic wall insufficiency by identifying its compensation, subcompensation and decompensation stages. For possible prediction of a high risk for death in each specific case, a correlation analysis of 23 factors presumably influencing on outcomes was carried out. A decisive rule of prediction was formulated.