Emergency surgery for large bowel obstruction caused by cancer.
نویسندگان
چکیده
There are several options for surgical treatment of large bowel obstruction caused by cancer, depending on location of obstruction, intraoperative local findings (perforation, peritonitis, bowel dilatation proximal to obstruction) and patients' condition. Resection and anastomosis as one stage surgery would be prefered procedure. Anastomotic leakage, on the other hand, highly elevates risk of mortality and mobidity. The most important question is whether to, in resectable cases, perform primary resection with anastomosis or not. This study was retrospective and included 40 patients that have undergone emergency surgery for large bowel obstruction caused by cancer. According to whether resection and anastomosis was made at initial surgery or not, patients were grouped in group A (N = 18) and group B (N = 21), respectively. We have analysed the type of surgical procedure, days of hospitalization, mortality, anastomotic leakeage, wound infection and other postoperative complications. Our results show that there is no major difference in mortality and morbidity in these two groups, suggesting that for selected patients primary resection and anastomosis is a safe option of tratment with acceptable risk. Since there are no strict guidelines or scorring system which would point the tratment option the decision about the choice of procedure still remains the burden of surgeon and depends on its experience and subspeciality. Our experience recomends primary resection and anastomosis except in cases of bowel perforation on tumor site, in cases of extreme dilatation and atony of bowel proximal to obstruction site and severe hypoproteinemia and anemia.
منابع مشابه
Ascaridial Volvulus: An Uncommon Cause of Ileal Perforation
Ascariasis is a common worm infestation in developing and under-developed countries. It is caused by the ingestion of food contaminated with Ascaris eggs from faeces and is more common in places with poor sanitation. Almost 25% of the world population is infested by Ascaris lumbricoides. Although ascariasis is a chronic disease, it can present as acute abdomen rarely. The wandering nature of As...
متن کاملAdhesive small bowel obstruction: where do we stand now?
Adhesive small bowel obstruction (ASBO) is one of the most frequently encountered disorders in Emergency Surgery Departments worldwide without negligible hospital admission rates and social costs (1,2). Notwithstanding significant improvements in techniques and materials, intra-abdominal adhesions following abdominal surgery still represent a major unsolved and debated issue harbouring challeng...
متن کاملبررسی بیماران مراجعه کننده به بیمارستان سینا با تشخیص انسداد روده طی سال های 75-1373
Intestinal obstruction is a significant disease specially in patients with previous surgery. Patients symptoms and signs usually are abdominal pain, vomiting, abdominal distention and obstipation. Adhesion bands secondary to previous abdominal surgery is the most common cause of small bowel obstruction and in USA up to 70% of small bowel obstruction is caused by adhesions. In our study adhesion...
متن کاملEndometriotic stricture of the sigmoid colon presenting with intestinal obstruction.
Endometriosis, a relatively common condition, rarely involves the bowel; even more rarely does it present as a large-bowel stricture with intestinal obstruction. We report the case of a young woman who presented to an emergency department with intestinal obstruction secondary to an endometriotic stricture of the sigmoid colon, without evidence of disease elsewhere in the peritoneal cavity. Alth...
متن کاملThe Association of Coloproctology of Great Britain and Ireland study of large bowel obstruction caused by colorectal cancer.
BACKGROUND This study was designed to investigate the early outcomes after surgical treatment of malignant large bowel obstruction (MBO) and to identify risk factors affecting operative mortality. METHODS Data were prospectively collected from 1046 patients with MBO by 294 surgeons in 148 UK hospitals during a 12-month period from April 1998. A predictive model of in-hospital mortality was de...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Collegium antropologicum
دوره 38 1 شماره
صفحات -
تاریخ انتشار 2014