[Experience in surgery of diastatic ruptures of the colon]

An experience with treatment of 58 patients operated upon for carcinoma of the colon complicated by acute intestinal obstruction and diastatic perforation has been analyzed, 13 patients had incomplete diastatic ruptures (tears) of the colon. In 23 patients the IV stage of the tumor process (remote metastases) were found and the other 35 patients had the III stage. In early terms after operation 37 (63.8%) patients out of 58 patients died. Lethality after incomplete diastatic ruptures of the colon made up 53.8%, and after diastatic perforation - 67.7%. The main cause of lethal outcomes was polyorganic insufficiency against the background of intoxication of mixed genesis (cancerous + endogenous). Ablation of colonic tumor is justified in cases of local peritonitis. Hemicolectomy with ablation of the diastatic rupture is indicated for the right-side localization of the tumor Obstructive resection is expedient for left-side localization of the tumor and rupture, the diastatic ruptures should be sutured or extraperitonized with application of cecostoma. Subtotal colectomy is possible for left-side localization of the tumor and diastatic ruptures of the right half of the colon. Symptomatic operations are indicated for canceromatosis of the peritoneum, terminal phase of peritonitis or infectious-toxic shock.