CURATIVE RESECTION AND PRIMARY ANASTOMOSIS FOLLOWING ACUTE OBSTRUCTION OF THE INTRA-OPERATIVELY DIAGNOSED MALIGNANT COLON

Dr Ajoy Kumar Kro; Dr Likha Raju; Dr Himat Daudung

Volume : VIII, Issue : VI, June - 2019

CURATIVE RESECTION AND PRIMARY ANASTOMOSIS FOLLOWING ACUTE OBSTRUCTION OF THE INTRA-OPERATIVELY DIAGNOSED MALIGNANT COLON

Dr Ajoy Kumar Kro, Dr Likha Raju, Dr Himat Daudung

Abstract :

Background and Objectives: An adenocarcinoma of colon is the most common malignancy tumour of the gastrointestinal tract1,2 and accounts for 16- 20% 0f acute large bowel obstruction1,2. The aim of present study was to evaluate the outcome of the patients presenting with acute obstruction of malignant colon diagnosed intra-operatively and treated by on-table manual decompression, curative resection, and primary anostomosis3,4,5,6,7,8,9,10,11. Methods: Eleven patients underwent an emergency exploratory laparotomy, and curative resection and primary anastomosis was done following acute obstruction of malignant colon between 1st Feuary, 2018 to 31st January, 2019 in the surgery department, Assam Medical College and Hospital, Diugarh, Assam. Carcinoma of colon was diagnosed intra-operatively and resected specimen was sent for histopathogical examination. Resection and anastomosis was followed by adjuvant chemotherapy consisting of 5-fluorouracil, Leucoverin and oxaliplatin1,2. Plain supine and upright abdominal radiographs and ultrasonography of abdomen were done in all patients. Results: All eleven patients were undergone exploratory laparotomy following acute obstruction of malignant colon. Seven patients were male and four patients were female. The left sided malignant colonic obstruction (72.72%) dominated the right sided malignant colon (27.28%) in present study. Surgical site infection (3 patients) was the most common complication. One patient developed anastomosis leakage. One patient expired in this study. Conclusions: Carcinoma of colon is one of the most common causes of large bowel obstruction. With the advance of guidelines on colon and rectal cancer emergencies, curative resection and primary anastomosis with on-table colonic manual decompression3, 16, becomes the standard procedure3, 15 in emergency malignant colonic obstruction. But one should not perform resection and primary anastomosis if there is complicated malignant large bowel obstruction in presence of other risk factor3.