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Total and subtotal colectomy for colonic obstruction.

E S Hughes, F T McDermott, A L Polglase

Diseases of the Colon and Rectum

|March 1, 1985

Summary

Total or subtotal colectomy is generally not recommended for elective colon cancer. Exceptions include younger patients, curative resections, or those with polyps, but not for partial obstructions.

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Area of Science:

Colorectal Surgery
Surgical Oncology
Gastroenterology

Background:

Colectomy, including total or subtotal procedures, is a significant surgical intervention for colon diseases.
The decision for colectomy in colon cancer requires careful consideration of patient factors and disease characteristics.

Purpose of the Study:

To define the appropriate indications for total or subtotal colectomy in the context of colonic cancer.
To evaluate the role of colectomy in managing obstructed colonic conditions.

Main Methods:

Review of surgical guidelines and clinical evidence regarding colectomy for colonic cancer.
Analysis of patient selection criteria for colectomy in elective and emergency settings.

Main Results:

Total or subtotal colectomy is not the primary choice for elective colonic cancer, except in specific scenarios (e.g., patients under 50, curative resection with polyps).
Routine colectomy is contraindicated when partial obstruction impedes colon preparation and examination.
Colectomy is a viable, though technically challenging, option for acutely obstructed colons, demanding experienced patient selection.

Conclusions:

The application of total or subtotal colectomy for colonic cancer should be judicious and based on specific patient and disease factors.
Colectomy for obstructed colons requires specialized surgical expertise.

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