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Endoscopic decompression using a transanal drainage tube for acute obstruction of the rectum and left colon as a bridge to curative surgery
Author(s) -
Xu M.,
Zhong Y.,
Yao L.,
Xu J.,
Zhou P.,
Wang P.,
Wang H.
Publication year - 2009
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2008.01595.x
Subject(s) - medicine , rectum , decompression , surgery , ileus , colonoscopy , enema , sigmoid colon , anastomosis , colorectal surgery , perforation , colorectal cancer , abdominal surgery , cancer , materials science , punching , metallurgy
Objective The aim of this study was to clarify the usefulness of the management of acute left colon and rectum obstruction because of colorectal carcinoma using a transanal ileus drainage tube before curative surgery. Method Forty‐six patients (24 males and 22 females, aged 24–94 years, mean = 56.2) treated between September 2005 and March 2007 for acute left colon and rectal obstruction were identified in a colorectal obstruction database, and their clinical and radiological features were reviewed. After a cleaning enema was administered, urgent colonoscopy was performed. Subsequently, endoscopic decompression using a ileus tube was attempted. Results Endoscopic decompression using the ileus tube was technically successful in 45 of 46 patients (97.8%). Perforation occurred in one patient 3 days later and emergent operation was performed. The site of obstruction was the rectum in 15 patients, the sigmoid colon in 18, the descending colon in 13. Following adequate cleansing of the colon, patients’ abdominal girth were decreased from 91 ± 4 cm before drainage to 82 ± 2 cm 7 days later, and one‐stage surgery after 8 ± 1 days (SD; range 7–10 days) were performed. No anastomotic leakage or postoperative stenosis occurred after operation. Conclusion Management of acute left colon and rectum obstruction because of colorectal carcinoma using the ileus tube was found to be effective and safe, considered as a bridged method before curative surgery.