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Updated: Aug 2, 2026
Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
[Comparison between resection and primary anastomosis and staged resection in obstructing adenocarcinoma of the left
José Eduardo de Aguilar-Nascimento1, Cervantes Caporossi, Mariana Nascimento
1Departamento de Cirurgia da Facultade de Ciências Médicas da Universidade Federal de Mato Grosso, Brasil. aguilar@terra.com.br e.sp.gov.br
Background:
The surgical option to deal with obstruction of the left side of the large bowel is still controversial.
Objective:
To report the experience of our group in the treatment of malignant left-sided colonic obstruction focusing on the immediate results using either one-stage resection and primary anastomoses or staged resection.
Patients/Methods:
Twenty-three patients (median age = 52 (39-84) years; 10 males and 13 females) with potentially resectable obstructed adenocarcinomas of the left colon entered the study. The patients were submitted to different surgical procedure: 14 (60,9%) underwent one stage colonic resection (intra-operative lavage of colon (n = 10) or subtotal colectomy (n = 4); resection and primary anastomoses group) and 9 patients (39,1%) underwent staged resection (Hartmann's operation (n = 4) or loop colostomy (n = 5); staged resection group).
Results:
Two patients (8,7%) died. All were from the staged resection group. Four patients (44,4%) of staged resection group did not complete the treatment with the closing of the colostomy. The incidence of complications was 28,6% in resection and primary anastomoses group (4/14) and 66,7% in staged resection group (6/9). Hospital stay was 15 (9-45) in staged resection patients and 8 (6-20) in resection and primary anastomoses group. There was one case (7,1%) of anastomotic dehiscence in resection and primary anastomoses group and two cases (22,2%) in staged resection group.
Conclusions:
The treatment of obstruction of left colon in one stage is safe and may be indicated for the management of the majority of cases.
