[Total abdominal colectomy in treatment of acute malignant obstruction of the left colon]

This paper deals with an experience of a total abdominal colectomy in acute malignant obstruction of the left sided colon. Ten patients were treated with total abdominal colectomy during 1991 with a high frequency of synchronous carcinoma (in two patients) and precancerous lesions (a big polyp in one patient) in total 30%. One patient died after the treatment (10%) and a complete dehiscence of the ileo-rectal anastomosis and reoperation on the ninth postoperative day. One patient had had an infection of the wound. Total abdominal colectomy is an operation which can have an important role in decreasing malignant reoccurrence, avoiding stoma in the postoperative period of one month in most patients. Absolute indication for total abdominal colectomy in patients with acute malignant obstruction of the left sided colon is the "closed loop" obstruction with a decompensated colon, as well as the factor of heredity in close relatives and the absence of locally spread tumors and metasthases disregarding the age of the patient and the competence of the ileocecal valvula.