대한대장항문학회

This study was undertaken to identify the causative factors that predispose to early<br>postoperative intestinal obstructions after the radical resection due to colorectal cancer,<br>and to determine their preventive operative techniques.<br>The records of 722 patients that had undergone radical resection due to colorectal<br>cancer at the Department of General Surgery, Kangbuk Samsung Hospital, between<br>January 1, 1986 and December 31, 1995, were reviewed. Among them, operative<br>treatments due to early postoperative intestinal obstructions were performed in 39<br>patients(5.4%).<br>The most common cause of intestinal obstruction in early postoperative period was<br>bowel adhesion, that was developed in 20 cases(51.3%), and next common cause was<br>internal herniation of bowel into the space between colostomy loop and lateral peritoneal<br>wall(3 cases, 7.7%), incarcerated herniation of small bowel into the reperitonealized pelvic<br>cavity(3 cases, 7.7%), pelvic abscess(1 case, 2.6%), and unknown causes(9 cases, 23.1%)<br>in descending frequency. Use of closed suction drains was responsible to development of<br>the 3rd and 4th causes.<br>As a result, during the radical resection due to colorectal cancer, meticulous<br>manupulation of bowels not to injure the bowel serosa, reperitonealization of pelvic floor<br>at narrow interval with inversion of its dissected edge, complete closure of the space<br>between colostomy loop and lateral wall of peritoneum, and adequate alternative use of<br>closed suction drain and natural drain according to the operative condition, should be<br>considered.<br>In conclusion, surgeons should pay more attention to the operating procedures to<br>lower the incidence of early postoperative intestinal obstruction.<br>