One-Stage Colectomy with Intraoperative Colonic Irrigation for Acute Left-Sided Malignant Colonic Obstruction

One-stage colectomy with intraoperative colonic irrigation (OCICI) may be useful in early resolution of acute left-sided malignant colonic obstruction (ALMCO). However, the clinical benefit of this technique has not been fully investigated.

Between January 2007 and July 2014, 451 patients underwent left hemicolectomy or sigmoidectomy for colon cancer, of whom 25 underwent OCICI for ALMCO. The medical records of the patients who underwent OCICI for ALMCO were compared to 174 medical records of a control population (without ALMCO) who were matched for tumor characteristics.

There were no statistically significant differences between the two groups in regard to age, sex, American Society of Anesthesiologists Physical Status, location of tumor, preoperative CEA levels, and previous abdominal surgeries. The OCICI for ALMCO group was associated with a longer operation time (153 ± 33 vs. 111 ± 47 min, p < 0.001). However, no significant differences were found in patient morbidity, the duration of the postoperative hospital stay, or the tumor pathology between the two groups. Univariate and multivariate analyses indicated that OCICI for ALMCO did not increase the risk of postoperative morbidity in patients with left-sided colon cancer.

OCICI for ALMCO did not increase the rate of morbidity or prolong the hospital stay duration compared to treatment of a control population.