SHORT-TERM OUTCOMES OF SINGLE-STAGE COLECTOMY WITH INTRAOPERATIVE COLONIC IRRIGATION FOR OBSTRUCTED LEFT-SIDED COLON CANCER

Thi Hoang Ngan Ngo1,, Thanh Son Truong2, Quang Huy Le2, Van Nghia Le3, Hoang Phu Tran3, Hanh Phuc Son3, Thanh Nhat Minh Le1, Dinh Cong Do4, Long Hien Ho5, Minh Tien Nguyen1
1 Can Tho University of Medicine and Pharmacy
2 Can Tho Cetral General Hospital
3 Nguyen Dinh Chieu Hospital
4 University of Medicine and Pharmacy at Ho Chi Minh city
5 Can Tho Oncology Hospital

Main Article Content

Abstract

Background: Surgical management of obstructive left colon cancer is still a controversial issue. The use of single-stage colectomy with intraoperative colon irrigation is seen as a compromise between single-stage and multi-stage colectomy, as it helps overcome the drawbacks of both methods and promotes their benefits. The purpose of this study was to assess the safety and efficacy of singlestage colectomy with intraoperative colon irrigation. Objectives: Short-term outcomes of single-stage colectomy with intraoperative colonic irrigation for obstructed left-sided colon cancer. Materials and methods: A combined retrospective and prospective case series report of 20 patients with obstructed left-sided colon cancer was collected from January 2020 to April 2024. Results: In total, there were 20 patients (10 men and 10 women) with a mean age was 57.25  13.63 years. The mean operation time was 259.5  60.47 minutes, and the mean number of harvested lymph nodes was 16.45 ± 4.78 nodes. All resection margins were found to be tumor-free (100% R0). The intraoperative complication rate was 15%, with 1 case of splenic flexure necrosis after irrigation and 2 cases of colonic serosal tears. The postoperative complication rate was 20%, with 5% of cases of anastomotic leakages, 10% of surgical site infections, and 5% of postoperative pneumonia. The median length of the postoperative hospital stay was 9.5 days and the mean time to first flatus was 3.75 ± 13.63 days. Conclusion: In carefully selected patients, a single-stage operation with intraoperative colonic irrigation was a feasible and safe approach for the treatment of left-sided colonic obstruction.

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References

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