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1 "Obstructive left colon cancer"
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Original Article
Colorectal cancer
Short- and long-term outcomes of subtotal/total colectomy in the management of obstructive left colon cancer
Jung Tak Son, Yong Bog Kim, Hyung Ook Kim, Chungki Min, Yongjun Park, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim
Ann Coloproctol. 2023;39(3):260-266.   Published online May 25, 2022
DOI: https://doi.org/10.3393/ac.2022.00101.0014
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  • 4 Web of Science
  • 6 Citations
AbstractAbstract PDF
Purpose
Surgical management of obstructive left colon cancer (OLCC) is still a matter of debate. The classic Hartmann procedure (HP) has a disadvantage that requires a second major operation. Subtotal colectomy/total abdominal colectomy (STC/TC) with ileosigmoid or ileorectal anastomosis is proposed as an alternative procedure to avoid stoma and anastomotic leakage. However, doubts about morbidity and functional outcome and lack of long-term outcomes have made surgeons hesitate to perform this procedure. Therefore, this trial was designed to provide data for morbidity, functional outcomes, and long-term outcomes of STC/TC.
Methods
This study retrospectively analyzed consecutive cases of OLCC that were treated by STC/TC between January 2000 and November 2020 at a single tertiary referral center. Perioperative outcomes and long-term outcomes of STC/TC were analyzed.
Results
Twenty-five descending colon cancer (45.5%) and 30 sigmoid colon cancer cases (54.5%) were enrolled in this study. Postoperative complications occurred in 12 patients. The majority complication was postoperative ileus (10 of 12). Anastomotic leakage and perioperative mortality were not observed. At 6 to 12 weeks after the surgery, the median frequency of defecation was twice per day (interquartile range, 1–3 times per day). Eight patients (14.5%) required medication during this period, but only 3 of 8 patients required medication after 1 year. The 3-year disease-free survival was 72.7% and 3-year overall survival was 86.7%.
Conclusion
The risk of anastomotic leakage is low after STC/TC. Functional and long-term outcomes are also acceptable. Therefore, STC/TC for OLCC is a safe, 1-stage procedure that does not require diverting stoma.

Citations

Citations to this article as recorded by  
  • Controversial issues of colon stenting in case of tumor obstructive intestinal obstruction: surgical and oncological aspects
    S.A. Aliyev, E.S. Aliyev, T.K. Aliyev
    Endoscopic Surgery.2025; 31(2): 65.     CrossRef
  • The Safety of Primary Anastomosis Without Protective Stoma in Emergency Left Colon Surgery: A Meta-Analysis
    Zhiyan Wang, Wentao Sheng, Senjie Dai, Xuanzhou Li, Guojian Lin, Xiaohong Kang
    Journal of Investigative Surgery.2025;[Epub]     CrossRef
  • Ileus After Colectomy in the Modern Era: A Population-Based Analysis
    Grace M. Crouch, Samantha Hendren, Kara K. Brockhaus, Wenjing Weng, Jami L. Boyd, Cheryl Rocker, Robert K. Cleary
    Diseases of the Colon & Rectum.2025; 68(8): 1001.     CrossRef
  • Influence of the type of anatomic resection on anastomotic leak after surgery for colon cancer
    Suat Chin Ng, Andrew McCombie, Frank Frizelle, Tim Eglinton
    ANZ Journal of Surgery.2024; 94(3): 424.     CrossRef
  • Complete Obstruction, a Real Risk Factor: A Comprehensive Study on Obstruction in Stage IIA Colon Cancer With Propensity Score Matching Analysis
    Soo Young Oh, Chan Wook Kim, Seonok Kim, Min Hyun Kim, Young Il Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu
    Clinical Colorectal Cancer.2024; 23(2): 135.     CrossRef
  • Can we use colon stenting in accelerated recovery programs for surgical treatment colon cancer complicated by obstructive intestinal obstruction? A literature review
    Saday A. Aliyev, Emil S. Aliyev
    Russian Journal of Oncology.2024; 29(2): 130.     CrossRef
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