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Goal: To report the epidemiological, diagnostic aspects and the results of the two-stage surgical management of cancer of the left colon in occlusion. Patients and Method: It was a retrospective study carried out over 3 years at the Center Hospitalier Universitaire of Libreville (January 2017 and December 2019), on cancer of the left colon in occlusion having undergone a colectomy in two stages. The epidemiological and diagnostic parameters, the results of surgical exploration, the operative technique and the post-operative procedures have been described. Results: Fifteen clinical files were retained including 9 men and 6 women. The average age was 52 years. Abdominal pain, cessation of materials and gas, and vomiting were the tell-tale signs. The abdomen without preparation showed hydroaeric levels (n = 11). Colonic lumen stenosis with segmental wall thickening was observed on abdominal computed tomography in all patients. The surgical approach was a mid-xypho-pubic laparotomy. The seats were: sigmoid colon (n = 7); the colonic (n = 4) and descending colon (n = 4) angle. It was performed: 12 colectomies (Hartmann), one colectomy (Bouilly Voklmann) and two permanent colostomies. The secondary locations were: hepatic metastases (n = 4), peritoneal carcinosis (n = 2). The histology was in favor of an adenocarcinoma (n = 13). Immediate morbidity was 20% and 13.4% respectively Conclusion: Occluded left colon cancer is common. Patients are young. We are campaigning for a tumor resection and a temporary left colostomy followed by a restoration of continuity in a second step.

Management of cancer of the left colon in occlusion by colectomy in two stages at the CHU of Libreville