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CARCINOMA OF THE UPPER LEFT COLON
Author(s) -
Hughes By E. S. R.
Publication year - 1966
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1966.tb06058.x
Subject(s) - medicine , suture line , surgery , anastomosis , carcinoma , colostomy , fibrous joint , transverse colon , bowel obstruction , colorectal cancer , perforation , dehiscence , general surgery , cancer , materials science , punching , metallurgy
Summary 1. Carcinoma occurs in the upper left colon a little less frequently than in other segments of the bowel. 2. Chronic ulcerative colitis is an important predisposing cause. 3. There is a high incidence of obstruction and of perforation in carcinoma in this segment. 34/96 had large bowel obstruction, and 6/96 had perforations of the tumour. 4. The resectability rate was 87.5 per cent. Palliative resection was performed in about a third of the cases, curative resection in just over half. 5. Segmental resection with end‐to‐end anastomosis, whether palliative or curative, had a very high incidence of suture line separation. Twelve out of 53 had suture line disruption, and 2/53 had suture line recurrence. 6. A total of 23 patients had subtotal colectomy with ileosigmoid anastomosis. There was one death, and one possible suture line leak. The bowel function has been excellent. 7. The treatment of large bowel obstruction caused by carcinoma of the upper left colon has been mostly by one of two methods — preliminary caecostomy or by subtotal colectomy. Both give good results. If a transverse colostomy has been performed in a subsequent subtotal colectomy, it is best to excise it.