Outcome after emergency subtotal/total colectomy compared to elective resection in patients with left-sided...

Long term survival of 72 patients who underwent an emergency one-stage subtotal/total colectomy with primary anastomosis for obstructing carcinoma of the left colon was compared with 141 patients who underwent an elective procedure for non-obstructing carcinoma of the same location. Patients who presented with intestinal obstruction were older than electively treated patients (68.5 versus 62.1 years), postoperative mortality was higher (13.8% versus 7.8%). 5-year survival rate of patients treated by R0 emergency subtotal/total colectomy was comparable to electively R0 resected patients (69% versus 61%). There was no significant difference in survival comparing the same Dukes' stage between the two groups. One-stage procedure could be regarded as a preferred method of treatment in patients with obstructing carcinoma of the left colon, either as a subtotal/total colectomy in cases when the colonic wall is endangered or as a resection with primary colo-colonic anastomosis after on-table lavage.