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Updated: May 21, 2026

Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection

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Laparoscopic management for acute malignant colonic obstruction.

Fan-Ming Chen¹, Tzu-Chieh Yin, Wen-Chieh Fan

¹Department of Surgery, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques

|June 9, 2012

Summary

Staged laparoscopic colectomy, involving initial colostomy then resection, is a feasible option for acute malignant colon obstruction. This approach offers a justified hospital stay compared to single-stage procedures.

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Area of Science:

Surgical Oncology
Minimally Invasive Surgery
Gastrointestinal Surgery

Background:

Acute malignant colon obstruction presents significant surgical challenges.
Traditional single-stage resections may carry high risks in emergency settings.

Purpose of the Study:

To assess the feasibility and effectiveness of a staged laparoscopic colectomy approach.
To evaluate outcomes for patients with acute malignant colon obstruction managed with this technique.

Main Methods:

Laparoscopic emergency blowhole colostomy for fecal diversion.
Subsequent elective laparoscopic colectomy with stoma reversal.
Analysis of patient demographics, operative details, and outcomes.

Main Results:

22 patients (14 male, 8 female; ages 42-79) underwent laparoscopic colostomy.
20 patients had successful elective laparoscopic resection and stoma takedown.
Mean hospital stay for resected patients was 20 ± 4.6 days; 15 patients had favorable outcomes at median 23-month follow-up.

Conclusions:

Staged laparoscopic colectomy is a feasible and effective treatment for acute malignant colon obstruction.
This technique provides comparable or justified hospital stays to single-stage resections.
It serves as a viable alternative when colonic stenting is unavailable.