Comparison between segmental left and extended right colectomies for obstructing left-sided colonic carcinomas

This study was designed to compare complications and functions following either radical extended right colectomy without colonic decompression or radical segmental left colectomy with intraoperative decompression for obstructed left-sided colonic carcinomas.

One hundred three patients with obstructed left-sided colonic carcinoma undergoing primary resection and anastomoses were studied.

There were 57 males and 46 females with a median age of 65 (range, 24-98) years and who had a median follow-up of 31 (range, 2-59) months. There were no leaks or intra-abdominal sepsis in the extended right colectomy group (44 patients) compared with one anastomosis leak in the segmental left colectomy (59 patients) group. Median hospital stay was 14 days in both groups, with a range of 8 to 36 days in the segmental left colectomy group and 7 to 44 days in those with extended right resection. One month after surgery, the patients who underwent segmental left colectomy had a median bowel movement of 3 (range, 1-6) per 24 hours compared with those with extended right colectomies who had a median of 5 (2-11) bowel movements per 24 hours. Bowel frequency decreased to four or less episodes per 24 hours in all patients in both groups at six months.

There was no significant difference between bowel function or complications between the two groups.