Safety of subtotal or total colectomy with primary anastomosis compared to Hartmann procedure for left-sided colon cancer obstruction or perforation
- Author:
Eun Do KIM
1
;
Jin Kwon LEE
;
Jin Kyu CHO
;
Jae Myung KIM
;
Ji Ho PARK
;
Ju Yeon KIM
;
Sang Ho JEONG
;
Young Tae JU
;
Chi Young JEONG
;
Eun Jung JUNG
;
Young Joon LEE
;
Soon Chan HONG
;
Seung Jin KWAG
Author Information
- Publication Type:Original Article
- Keywords: Subtotal colectomy; Anastomosis; Colonic neoplasms; Hartmann procedure
- MeSH: Anastomotic Leak; Colectomy; Colon; Colonic Neoplasms; Defecation; Emergencies; Humans; Mortality; Retrospective Studies
- From: Korean Journal of Clinical Oncology 2019;15(2):106-111
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: Whether subtotal or total colectomy with primary anastomosis (PA) is safer than Hartmann procedure (HP) for left-sided colon cancer obstruction or perforation remains controversial. The purpose of this study was to compare postoperative morbidity, mortality, and defecation frequency between PA and HP for left-sided colon cancer obstruction or perforation.METHODS: This retrospective study enrolled 54 patients from January 2014 to February 2018 who underwent emergency surgery due to left-sided colon cancer obstruction or perforation.RESULTS: PA was carried out in 20 patients while HP was performed for 34 patients. Thirty-day mortality did not show significant difference between the two groups (15.0% vs. 14.7%, P=1.000). No anastomotic leakage occurred in PA group while three (8.8%) cases of stump leakage occurred in HP group. Stoma repair was performed for 13 cases (44.8%) and stoma reformation was performed for one case in HP group (7.7%). Stoma related complications occurred in five cases (17.24%). For patients after stoma repair, defecation frequency at 3 months after operation was 2.91±2.88 times per day in PA group and 2.86±2.63 times per day in HP group. At 1 year after operation, defecation frequency was changed to 1.40±1.12 times per day in PA group and 1.17±0.39 times per day in HP group.CONCLUSION: Primary ileosigmoid or ileorectal anastomosis for left-sided colon cancer obstruction or perforation is safe, and shows similar outcome of defecation frequency compared to HP.
