Application of The Double Cavity Casing Negative Pressure Drainage by Inside and Outside of The Intestine in The Primary Resection and Anastomosis of Left Colon Cancer Combined with Acute Obstruction_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHANGJia-yue , HUANGYong-hong , PANGFei-xiong , LENGJin-li , LISong-ming , HEHui , YANGTao , HEHong-yan , YINQi

Department of General Surgery, No. 303 Hospital of PLA, Nanning 530021, Guangxi Zhuang Autonomous Region, China;

Corresponding?author：

ZHANGJia-yue, Email: 13321717512@163.com

Keywords：

Left colon cancer; Acute obstruction; Double cavity casing negative pressure drainage; Effect

DOI：

10.7507/1007-9424.20150082

Video：

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Objective To investigate the feasibility and safety of the double cavity casing negative pressure drainage by inside and outside of the intestine in the primary resection and anastomosis of left colon cancer combined with acute obstruction. Methods Eighty-one cases of left colon cancer combined with acute obstruction who underwent surgeries in our hospital from January 2009 to December 2012 were collected prospectively, and were divided into one-stage surgery group (n=41) and control group (n=40). Cases of one-stage surgery group received double cavity casing negative pressure drainage by inside and outside of the intestine in the primary resection and anastomosis, and cases of control group underwent two-stage surgeries. Comparison of operation time, blood loss, time of anal exhaust after operation, hospital stay, hospital expense, and incidence of complication between the 2 groups was performed. Results There were no significant difference in the operation time[(166±19) minutes vs. (173±23) minutes], blood loss[(253±42) mL vs. (273±50) mL], and time of anal exhaust after operation[(3.24±0.73) days vs. (3.50±0.95) days]beeween one-stage surgery group and control group, but hospital stay[(15.1±2.3) days vs. (23.1±4.1) days]and hospital expense[(3.70±0.68) ×10⁵ yuan vs. (5.77±0.95) ×10⁵ yuan]of one-stage surgery group were lower than those of control group (P<0.05). In addition, there were no significant difference in the incidences of wound infection[7.3% (3/41) vs. 10.0% (4/40)], intraabdominal infection[4.9% (2/41) vs. 10.0% (4/10)], pulmonary infection[12.2% (5/41) vs. 15.0% (6/40)], and anastomotic leakage[2.4% (1/41) vs. 5.0% (2/40)]beeween one-stage surgery group and control group (P>0.05). All of the cases were followed up for 1-36 months, and the median time were 22 months. There were no significant difference in the mortality[0 (0/41) vs. 2.5% (1/40)], recurrence rate[2.4% (1/41) vs. 5.0% (2/40)], and metastasis rate[7.3% (3/41) vs. 10.0% (4/40)]beeween one-stage surgery group and control group too (P>0.05). Conclusion In the case of negative pressure drainage of double cavity casing, underwent decompression of the small bowel, and irrigation of colon, the primary resection and anastomosis of left colon cancer combined with acute obstruction was safe and feasible.

Citation： ZHANGJia-yue, HUANGYong-hong, PANGFei-xiong, LENGJin-li, LISong-ming, HEHui, YANGTao, HEHong-yan, YINQi. Application of The Double Cavity Casing Negative Pressure Drainage by Inside and Outside of The Intestine in The Primary Resection and Anastomosis of Left Colon Cancer Combined with Acute Obstruction. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(3): 307-310. doi: 10.7507/1007-9424.20150082 Copy

1.	?Mainar A, Tejero E, Maynar M, et al. Colorectal obstruction:treatment with metallic stents. Radiology, 1996, 198(3):761-764.
2.	Boorman P, Soonawalla Z, Sathananthan N, et al. Endoluminal stenting of obstructed colorectal tumours. Ann R Coll Surg Engl, 1999, 81(4):251-254.
3.	汪建平. 大腸癌并急性結腸梗阻的處理. 中國實用外科雜志, 2000, 20(8):459-461.
4.	吳善水, 吳榮興, 王文武. 合并腸梗阻的左半結腸癌一期切除吻合術41例. 中國中西醫結合外科雜志, 2008, 14(5):471-472.
5.	Runkel NS, Schlag P, Schwarz V, et al. Outcome after emergency surgery for cancer of the large intestine. Br J Surg, 1991, 78(2):183-188.
6.	Gandrup P, Lund L, Balslev I. Surgical treatment of acute malignant large bowel obstruction. Eur J Surg, 1992, 158(8):427-430.
7.	Mcintyre R, Reinbach D, Cuschieri RJ. Emergency abdominal surgery in the elderly. J R Coll Surg Edinb, 1997, 42(3):173-178.
8.	Arslan K, Ery?lmaz MA, Oku? A, et al. Is total-subtotal colectomy and primary anastomosis a good treatment alternative in malignant obstructive lesions of the left colon?. Ulus Travma Acil Cerrahi Derg, 2012, 18(4):311-316.
9.	Tekkis PP, Kinsman R, Thompson MR, et al. The association of coloproctology of Great Britain and Ireland study of large bowel obstruction caused by colorectal cancer. Ann Surg, 2004, 240(1):76-81.
10.	Meyer F, Marusch F, Coch A, et al. Emergency operation in carcinomas of the left colon:value of Hartmann's procedure. Tech Coloproctol, 2004, 8 Suppl 1:s226-s229.
11.	Zorcolo L, Covotta L, Carlomagno N, et al. Safety of primary anastomosis in emergency colo-rectal surgery. Colorectal Dis, 2003, 5(3):262-269.
12.	Villar JM, Martinez AP, Villegas MT, et al. Surgical options for malignant left-sided colonic obstruction. Surg Today, 2005, 35(4):275-281.
13.	Biondo S, Pares D, Frago R, et al. Large bowel obstruction:predictive factors for postoperative mortality. Dis Colon Rectum, 2004, 47(11):1889-1897.
14.	Deen KI, Madoff RD, Goldberg SM, et al. Surgical management of left colon obstruction:the University of Minnesota experience. J Am Coll Surg, 1998, 187(6):573-576.
15.	Hennekinne-Mucci S, Tuech JJ, Brehant O, et al. Emergency subtotal/total colectomy in the management of obstructed left colon carcinoma. Int J Colorectal Dis, 2006, 21(6):538-541.
16.	Nraaynsingh V, Ariyanayagam D, Pooran S. Primary repair of colon injuries in a developing country. Br J Surg, 1991, 78(3):319-320.
17.	張磊, 陳亞進, 商昌珍, 等. 左半結腸梗阻全結腸灌洗一期切除吻合術. 中華消化外科雜志, 2007, 6(5):392-393.
18.	楊昌平, 陳玉秀, 郭宏榮. 急診左半結腸梗阻一期切除吻合. 中華胃腸外科雜志, 2001, 4(3):196-197.
19.	Sozen S, Das K, Erdem H, et al. Resection and primary anastomosis with modified blow-hole colostomy or Hartmann's procedure. Which method should be performed for gangrenous sigmoid volvulus?. Chirurgia (Bucur), 2012, 107(6):751-755.
20.	潘春球, 周望梅, 余壁湘, 等. 術中結腸灌洗Ⅰ期治療梗阻性左半結腸癌與常規手術臨床對比研究. 南方醫科大學學報, 2010, 30(3):605-607.
21.	王亞軍, 李非, 方育, 等. 左半結腸癌腸梗阻術中排便一期切除吻合術的臨床應用. 中華胃腸外科雜志, 2010, 13(1):36-39.
22.	Jiménez Fuertes M, Costa Navarro D. Resection and primary anastomosis without diverting ileostomy for left colon emergencies:is it a safe procedure?. World J Surg, 2012, 36(5):1148-1153.
23.	渠時學, 王雪晨, 劉繼祥, 等. 自制可固定式結直腸雙腔引流管應用于治療左半結腸和直腸損傷的研究. 中國綜合臨床, 2003, 19(3):273-274.

1. ?Mainar A, Tejero E, Maynar M, et al. Colorectal obstruction:treatment with metallic stents. Radiology, 1996, 198(3):761-764.
2. Boorman P, Soonawalla Z, Sathananthan N, et al. Endoluminal stenting of obstructed colorectal tumours. Ann R Coll Surg Engl, 1999, 81(4):251-254.
3. 汪建平. 大腸癌并急性結腸梗阻的處理. 中國實用外科雜志, 2000, 20(8):459-461.
4. 吳善水, 吳榮興, 王文武. 合并腸梗阻的左半結腸癌一期切除吻合術41例. 中國中西醫結合外科雜志, 2008, 14(5):471-472.
5. Runkel NS, Schlag P, Schwarz V, et al. Outcome after emergency surgery for cancer of the large intestine. Br J Surg, 1991, 78(2):183-188.
6. Gandrup P, Lund L, Balslev I. Surgical treatment of acute malignant large bowel obstruction. Eur J Surg, 1992, 158(8):427-430.
7. Mcintyre R, Reinbach D, Cuschieri RJ. Emergency abdominal surgery in the elderly. J R Coll Surg Edinb, 1997, 42(3):173-178.
8. Arslan K, Ery?lmaz MA, Oku? A, et al. Is total-subtotal colectomy and primary anastomosis a good treatment alternative in malignant obstructive lesions of the left colon?. Ulus Travma Acil Cerrahi Derg, 2012, 18(4):311-316.
9. Tekkis PP, Kinsman R, Thompson MR, et al. The association of coloproctology of Great Britain and Ireland study of large bowel obstruction caused by colorectal cancer. Ann Surg, 2004, 240(1):76-81.
10. Meyer F, Marusch F, Coch A, et al. Emergency operation in carcinomas of the left colon:value of Hartmann's procedure. Tech Coloproctol, 2004, 8 Suppl 1:s226-s229.
11. Zorcolo L, Covotta L, Carlomagno N, et al. Safety of primary anastomosis in emergency colo-rectal surgery. Colorectal Dis, 2003, 5(3):262-269.
12. Villar JM, Martinez AP, Villegas MT, et al. Surgical options for malignant left-sided colonic obstruction. Surg Today, 2005, 35(4):275-281.
13. Biondo S, Pares D, Frago R, et al. Large bowel obstruction:predictive factors for postoperative mortality. Dis Colon Rectum, 2004, 47(11):1889-1897.
14. Deen KI, Madoff RD, Goldberg SM, et al. Surgical management of left colon obstruction:the University of Minnesota experience. J Am Coll Surg, 1998, 187(6):573-576.
15. Hennekinne-Mucci S, Tuech JJ, Brehant O, et al. Emergency subtotal/total colectomy in the management of obstructed left colon carcinoma. Int J Colorectal Dis, 2006, 21(6):538-541.
16. Nraaynsingh V, Ariyanayagam D, Pooran S. Primary repair of colon injuries in a developing country. Br J Surg, 1991, 78(3):319-320.
17. 張磊, 陳亞進, 商昌珍, 等. 左半結腸梗阻全結腸灌洗一期切除吻合術. 中華消化外科雜志, 2007, 6(5):392-393.
18. 楊昌平, 陳玉秀, 郭宏榮. 急診左半結腸梗阻一期切除吻合. 中華胃腸外科雜志, 2001, 4(3):196-197.
19. Sozen S, Das K, Erdem H, et al. Resection and primary anastomosis with modified blow-hole colostomy or Hartmann's procedure. Which method should be performed for gangrenous sigmoid volvulus?. Chirurgia (Bucur), 2012, 107(6):751-755.
20. 潘春球, 周望梅, 余壁湘, 等. 術中結腸灌洗Ⅰ期治療梗阻性左半結腸癌與常規手術臨床對比研究. 南方醫科大學學報, 2010, 30(3):605-607.
21. 王亞軍, 李非, 方育, 等. 左半結腸癌腸梗阻術中排便一期切除吻合術的臨床應用. 中華胃腸外科雜志, 2010, 13(1):36-39.
22. Jiménez Fuertes M, Costa Navarro D. Resection and primary anastomosis without diverting ileostomy for left colon emergencies:is it a safe procedure?. World J Surg, 2012, 36(5):1148-1153.
23. 渠時學, 王雪晨, 劉繼祥, 等. 自制可固定式結直腸雙腔引流管應用于治療左半結腸和直腸損傷的研究. 中國綜合臨床, 2003, 19(3):273-274.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of The Double Cavity Casing Negative Pressure Drainage by Inside and Outside of The Intestine in The Primary Resection and Anastomosis of Left Colon Cancer Combined with Acute Obstruction

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