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Scripta Scientifica Medica

Tactics of treatment of acute left colon cancer obstruction

I Blagov, M. Radionov, S. Kovachev, O. Tomov, A. Simeonov, T. Pojarliev


Back ground: Advanced colorectal cancer is commonly associated with colon obstruction/between 15-20% of patients with colonic cancer/ or/and tumor infiltration to adjacent organs. We set out to study in-hospital morbidity and mortality after operations of acute left colon cancer obstruction.

Methods: From 2000 to 2010 the medical records of 204 cases /15.1%/ of acute left colon cancer obstruction were reviewed from total of 1351 patients who were operated from colorectal cancer. Results: The types of operations were a Hartmann procedure in 78 patients /38.2%/, colostomy in 58 patients /29.4%%, a type of colectomy with ileo-coloanastomosis in 54 patients /26.5%/ and a standard resection in 14 patients /6.8%/. The following early complications were occurred: anastomotic leakage in 4 patients, wound infections in 5 patients, dehiscence of operative wound in 2 patients. The in-hospital mortality rate was 11.3%.

Conclusions: The emergency management of acute left-sided colonic obstruction remains controversial. The one-stage resection anastomosis which could be subtotal colectomy or segmental resection is useful and the preferred choice for low risk patients. Simple colostomy or Hartmann procedure should be re served for high risk patients. Colonic stenting is the best option either for palliation or as a bridge to surgery.


acute left colon cancer obstruction; intestinal obstruction; colorectal cancer

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About The Authors

I Blagov
Surgery clinic, University hospital St. Anna of Sofia

M. Radionov
Surgery clinic, University hospital St. Anna of Sofia

S. Kovachev
Surgery clinic, University hospital St. Anna of Sofia

O. Tomov
Surgery clinic, University hospital St. Anna of Sofia

A. Simeonov
Surgery clinic, University hospital St. Anna of Sofia

T. Pojarliev
Surgery clinic, University hospital St. Anna of Sofia

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