Abstract
From 1973 to 1989, 90 cases of obstructing carcinoma of the left colon were treated with five different operative procedures, the incidence of anastomotic leakage was 6.7%, the operative mortality was 7.8%. Among all the patients, 14 cases were treated by primary resection with anastomosis. Anastomotic leakage occurred in 6 cases, and 5 of them were died. Of 25 cases with the traditional staged management, the tumors were resected only in 20 cases, and not resectable in the other 5 patients. 19 with modified Hartmann’s procedure and 26 with extended right hemicolectomy with ileorectal or low ileosigmoid anastomosis gave satisfactory results. In terms of this series, the five-year survival rate in primary resection group was significantly higher than that in staged resection group (P<0.05). It is suggested that extended right hemicolectomy or modified Hartmann’s procedure in cases of acute cancerous obstruction of the left colon would be favord.
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