Percutaneous decompression and irrigation for large bowel obstruction. New approach

Area of Science:

• Gastroenterology
• Surgical Oncology
• Interventional Radiology

Background:

• Colonic obstruction presents an emergency surgical challenge.
• Sigmoidal and rectosigmoidal carcinomas are common causes of large bowel obstruction.
• Emergency surgery for colonic obstruction carries significant risks.

Purpose of the Study:

• To introduce and evaluate percutaneous decompression and irrigation as a safe emergency procedure for large bowel obstruction.
• To assess the efficacy of this minimally invasive technique in preparing patients for definitive surgery.
• To determine if the procedure allows for deferral of emergency surgery and facilitates a one-stage definitive procedure.

Main Methods:

• Percutaneous decompression and irrigation of the obstructed large bowel.
• Procedure performed in 28 patients with colonic obstruction due to sigmoidal or rectosigmoidal carcinoma.
• Monitoring for complications during and after the procedure.

Main Results:

• The procedure was performed successfully in 28 patients.
• No complications were reported during or after the percutaneous decompression and irrigation.
• Patients were adequately prepared and investigated for definitive colonic surgery.
• Definitive surgery was performed 36-48 hours after decompression.

Conclusions:

• Percutaneous decompression and irrigation is a simple and safe emergency procedure for large bowel obstruction.
• The technique effectively defers the need for immediate emergency surgery.
• It enables a one-stage definitive surgical procedure during the same admission, improving patient management.