Primary resection and anastomosis in obstructed descending colon due to cancer

Intraoperative colonic irrigation followed by one-stage resection is gaining popularity as the optimal surgical treatment for left-sided colonic obstruction. However, its efficacy and potential hazards have not been adequately tested in obstruction due to colonic cancer. We analyzed the early results of 23 consecutive patients with obstructive left-sided colonic carcinoma treated by primary resection and anastomosis following intraoperative antegrade colonic lavage. Two patients (8.6%) died, one from complication of anastomotic leakage. The significant postoperative complications were chest infection in three (13%) and wound infection in seven (30.4%). The average hospital stay was 16.5 days. The results of this study suggest that intraoperative bowel irrigation permits one-stage resection and anastomosis to be conducted with reasonable safety provided care is taken in operative techniques.