Strategy of decompression for primary resection and anastomosis in left-sided colonic carcinoma with acute obstruction

【Objective】 To define the best primary intention-to-treat strategy of decompression for primary resection and anastomosis in left-sided colonic carcinoma with acute obstruction is with colonic irrigation or without. 【Methods】 A retrospective study was conducted to analyze 57 patients underwent primary resection and anastomosis in left-sided colonic carcinoma with acute obstruction, from April 2005 to April 2013, who were divided into group with(n =37) and without colonic irrigation(n =20) according to operational technique. The characteristics of operation and short outcome were compared. 【Results】 Results showed no significant difference in age, sex, tumor size, serum CEA level, tumor location, gross classification, histologic type, broder grade, lymphatic metastasis and TNM stage between two group, of which is parallel. Without irrigation group has shorter operative time than irrigation group(176.0 ± 22.1 vs 245.0 ± 11.2, P =0.032). Bowel sound Recov- ery time and nasogastric tube removal time was no significant difference(P 0.05), but hospitalization time of without irrigation group was significantly shorter(9.0 ± 1.4 vs 14.0 ± 3.4, P =0.047). No death was found in without irrigation group, while 2 patients were dead in irrigation group. The incidence of postoperative com-plications was significantly higher in irrigation group than without irrigation(P =0.034), but the incidence of two groups in the perioperative mortality, sepsis, anastomotic fistula shows non-significant difference(P 0.05). 【Conclusion】Based on short outcome, without intraoperative colonic irrigation is the better technique of primary resection and anastomosis in left-sided colonic carcinoma with acute obstruction.