대한대장항문학회

Purpose : Although the cancer of the right side colon is usually managed by primary<br>anastomosis following resection, but the optimal management of obstructing left side colon<br>cancer is controversial. So, we performed this study to evaluate the feasibility and safety of<br>subtotal or total colectomy as a method of one-stage operation in malignant obstruction of<br>left side colon. Methods : We analyzed retrospectively 35 patients with obstructing left side<br>colon cancer among 74 cases of obstructing colorectal carcinoma who were treated surgically<br>at the Wallace Memorial Baptist Hospital from January 1989 to December 1998. Results :<br>One-stage operation was performed in 16 patients (subtotal colectomy in 13, total colectomy<br>in 3). Staged operation was performed in 15 patients (two-stage operation in 10, three-stage<br>operation in 5). Palliative colostomy was performed in 4 patients. Postoperative complications<br>had been developed in 6 patients (37.5%) with subtotal or total colectomy group and in 7<br>patients (46.7%) with staged operation group. The postoperative frequent bowel movement<br>was shown in 13 patients (81.2%) with subtotal or total colectomy group and in 7 patients<br>(70.0%) with staged operation group. Frequent bowel movement was improved with<br>antidiarrheal medications within 3 months. Operative mortality was 6.3% (1 patient) in<br>subtotal or total colectomy group and 13.3% (2 patients) in staged operation group. There<br>was no significant difference in morbidity and mortality statistically between two groups.<br>Conclusions : We believe that subtotal or total colectomy as a method of one-stage operation<br>can be performed with acceptable morbidity and mortality in selected patients with<br>obstructing left side colon cancer.<br>