대한대장항문학회

Intraoperative antegrade colonic irrigation for single stage procedure in left colon cancer obstruction is a preferred technique recently however, synchronous pathology cannot be detected. A new device that enables easy intraoperative irrigation<br>and<br>colonoscopy before resection of tumor was devised. <b>Purpose:</b> To evaluate the efficacy of the new device for single stage procedure in left colon cancer obstruction. <b>Methods:</b> The new device (NICI; MITech co., Ltd, Seoul, Korea)<br>consists<br>of a<br>Y-shaped teflon tube of maximum diameter 2.9, 3.5 and 4.1 cm, one proximal end is designed to connect with the dilated colon just proximal to the lesion. Two distal branches are for drainage of fecal matter and for retrograde insertion of<br>irrigation<br>catheter and subsequent colonoscope respectively. <b>Results:</b> There were 53 patients (27 male, median age 64, range; 28∼82) who underwent this procedure. No extraintestinal leaks were encountered. The volume of saline used was 12 (range; 6<br>to<br>27)<br>Liters over 14 (range; 9 to 22) minutes. Subsequent colonoscopic examination added 10 (range, 8 to 15) minutes to the entire operation in 28 patients. There were one anastomotic leakage and 2 wound infections, however, there was no operative<br>mortality.<br>On-table colonoscopy resulted in extended resection in 3 cases because of synchronous malignancy in frozen biopsy and found synchronous polyps in 13 of 28 cases. <b>Conclusions:</b> The new device enabled safe, simple and time saving single stage<br>surgical management of left colon cancer obstruction. The ability to perform on-table colonoscopy enabled treatment of synchronous bowel pathology.<br>