The Use оf Intraoperative Colonic Irrigation in Surgical Treatment of Obstructing Cancer of the Left Colon

Abstract

Purpose. Study of technical options and immediate results of primary anastomoses using intraoperative colonic irrigation in the surgical treatment of left-sided colonic tumor obstruction.Material and methods. Of the 128 patients with left-sided colonic obstruction, 20 patients underwent surgery with intraoperative colonic lavage and the formation of a primary colonic anastomosis. The mean age was 61.7 1.4 years. In 5 patients, the compensated stage of colonic malignant obstruction was detected, in 8 patients - subcompensated, in 7 patients - decompensated. Colon icirrigation was carried out by means of antegrade jet injection of 8 -10 liters of isoosmolar solution of electrolytes and was terminated by the introduction of enterosorbent microsorb-P. In 11 cases left-sided hemicolectomy was performed in patients and in 9 cases - resection of the sigmoid colon with primary anastomosis.Results. After surgical interventions various complications were observed in 7 patients. In 2 patients afailure of anastomosis was revealed, the successful treatment of which did not require repeated surgical procedures. In the postoperative period 1 (5.0%) patient died on the 4th day after surgical intervention from cardiopulmonary insufficiency on the basis of concomitant pathology.Conclusion. In the conditions of specialized surgical hospitals after careful evaluation of operational risk with obstructing cancer of the left colon it is possible to use segmental resections of the colon with the imposition of a primary anastomosis with mandatory use of intraoperative colonic lavage . This tactic helps to increase the effectiveness of surgical interventions and provides early rehabilitation of operated patients.