Totally laparoscopic treatment of colonic obstruction due to colon cancer in 71 patients. Texas Endosurgery Institute experience.

Miguel A Hernandez, MD, Morris E Franklin Jr., MD, FACS, Jeffrey L Glass, MD, FACS, Mark Glover, MD, Ekong Uffort, MD, Bryson Nicholson, MD. Texas Endosurgery Institute

Background: Several treatment options for colonic obstruction are available. Loop colostomy, Hartmann’s procedure, one stage surgery, and colonic stenting have been selected as options for the management of colonic obstruction. The choice of treatment depends upon patient’s characteristics, disease presentation, and preference of the surgeon as well. Laparoscopic approach has gained more and more popularity on colorectal surgery field. The objective of this study is to demonstrate the feasibility and safety of laparoscopic approach in patients with colonic obstruction caused by colon cancer.

Material and Methods: We designed a nonrandomized prospective study of all consecutive patients with obstructive colonic tumors. We recollected data from April 1992 to September 2015 and were analyzed.

Results: Laparoscopic successfully treatment was in 69 patients of 71. Of these patients 25 were females and 46 were male. The site of cancer was: 20 cecum cancer, 4 transverse colon cancer, 7 descending colon cancer, 24 sigmoid colon cancer, and 16 rectal cancer. We performed 21 right hemicolectomies, 4 transverse colon resections, 7 left hemicolectomies, 20 sigmoid colon resection, 10 low anterior resection, 7 Hartmann’s procedure, and 2 laparotomies due to severe colon dilatation and multiple adhesions caused by multiple prior surgeries.

Conclusions: In experienced hands, colonic obstruction due to malignant disease can be safely and effectively treated by laparoscopic approach. Current trends toward minimally invasive surgery have allowed us to take better and safer measures to provide patients with the best possible medical and surgical care. In our perspective, laparoscopic surgery for obstructive colonic cancer offers the patient the known benefits of laparoscopic surgery and a safe option for this disease.

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