EMERGENCY SUBTOTAL TOTAL COLECTOMY IN ACU TELY OBSTRUCTED CANCER OF THE LEFT COLON/

Purpose: The aim of the study was to evaluate the results of managemen t of acutely obstructed carcinoma of the left colon by emergency subto tal/total colectomy (STC) with immediate anastomosis without diversion . Methods: STC was performed in 48 patients (mean age 72 years). Inclu sion criteria were reasonable operative risk, resectable acutely obstr ucted carcinoma, massively-distended colon of dubious viability, signs of impending cecal perforation. Results: Postoperative mortality was 6.2 % (n = 3). result of cardiopulmonary complications; an 83 year-old female dies as a result of an anastomotic dehiscence. Morbidity was 1 2.4 % (n = 6) including one fistula which recovered without surgery. T here were 4 synchronous colon cancers. Six months after surgery, the m ean daily stool frequency was 2 after STC, and 3 after TC. Conclusion: Emergency STC achieves in one stage relief of bowel obstruction and t umor resection by encompassing a massively distended and fecal-loaded colon with ischemic lesions, ensures restoration of gut continuity via a ''safe'' anastomosis and removes occasional synchronous carcinoma.