The feasibility and safety of deeply inserted enema tubes for acute malignant left-hemicolon obstruction: an alternative solution in developing countries

Background and aimsDisposable enema kits are commonly used for bowel preparation, with the anal tube typically positioned near the rectal ampulla. This study assesses the feasibility and safety of deeply inserting an enema tube in cases of acute malignant left-hemicolon obstruction.MethodsA retrospe...

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Main Authors: Xinxiang Huang, Lijuan Zheng, Huifeng Wu, Xiaomei Li, Conghua Song
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1522138/full
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author Xinxiang Huang
Lijuan Zheng
Huifeng Wu
Xiaomei Li
Xiaomei Li
Conghua Song
author_facet Xinxiang Huang
Lijuan Zheng
Huifeng Wu
Xiaomei Li
Xiaomei Li
Conghua Song
author_sort Xinxiang Huang
collection DOAJ
description Background and aimsDisposable enema kits are commonly used for bowel preparation, with the anal tube typically positioned near the rectal ampulla. This study assesses the feasibility and safety of deeply inserting an enema tube in cases of acute malignant left-hemicolon obstruction.MethodsA retrospective analysis was conducted on 42 patients who underwent emergency endoscopic decompression via a deeply inserted enema tube for acute malignant left-hemicolon obstruction from January 2021 to September 2024 at a single center, the Endoscopy Centre of the Affiliated Hospital of Putian University. This analysis covered intubation duration, the success rate of intubation, the obstruction relief rate, as well as associated adverse events.ResultsThirty-six patients achieved successful tube placement, attaining a one-time success rate of 85.7% (36/42). Following successful intubation, the abdominal circumference decreased to a mean of (85.2 ± 3.0)% of the original value on the subsequent day (P < 0.01). Abdominal plain films depicted a significant reduction in both the quantity of gas-fluid levels and the maximal transverse diameter of the proximally obstructed colon [(4.5 ± 1.2) cm versus (7.4 ± 0.8) cm, P < 0.01]. Within 48 hours, C-reactive protein (CRP) levels plummeted by over 50%, and bowel sounds normalized within 2 - 5 days. During surgery, the bowel exhibited only slight or negligible dilation and edema, with no conspicuous fecal residues detected in the colonic cavity. Furthermore, no severe tube-related adverse events occurred either during or after intubation.ConclusionThe application of deeply inserted enema tubes proves to be both feasible and safe in treating acute malignant left-hemicolon obstruction, thus presenting itself as a viable alternative approach in developing countries.
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spelling doaj-art-053fa31c25f2475da3bb691b9b6b0d152025-08-20T03:17:31ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-04-011510.3389/fonc.2025.15221381522138The feasibility and safety of deeply inserted enema tubes for acute malignant left-hemicolon obstruction: an alternative solution in developing countriesXinxiang Huang0Lijuan Zheng1Huifeng Wu2Xiaomei Li3Xiaomei Li4Conghua Song5Gastrointestinal Endoscopy Center, The Affiliated Hospital of Putian University, Putian, Fujian, ChinaGastrointestinal Endoscopy Center, The Affiliated Hospital of Putian University, Putian, Fujian, ChinaGastrointestinal Endoscopy Center, The Affiliated Hospital of Putian University, Putian, Fujian, ChinaSchool of Basic Medicine, Putian University, Putian, Fujian, ChinaKey Laboratory of Translational Tumor Medicine in Fujian Province, Putian University, Putian, Fujian, ChinaGastrointestinal Endoscopy Center, The Affiliated Hospital of Putian University, Putian, Fujian, ChinaBackground and aimsDisposable enema kits are commonly used for bowel preparation, with the anal tube typically positioned near the rectal ampulla. This study assesses the feasibility and safety of deeply inserting an enema tube in cases of acute malignant left-hemicolon obstruction.MethodsA retrospective analysis was conducted on 42 patients who underwent emergency endoscopic decompression via a deeply inserted enema tube for acute malignant left-hemicolon obstruction from January 2021 to September 2024 at a single center, the Endoscopy Centre of the Affiliated Hospital of Putian University. This analysis covered intubation duration, the success rate of intubation, the obstruction relief rate, as well as associated adverse events.ResultsThirty-six patients achieved successful tube placement, attaining a one-time success rate of 85.7% (36/42). Following successful intubation, the abdominal circumference decreased to a mean of (85.2 ± 3.0)% of the original value on the subsequent day (P < 0.01). Abdominal plain films depicted a significant reduction in both the quantity of gas-fluid levels and the maximal transverse diameter of the proximally obstructed colon [(4.5 ± 1.2) cm versus (7.4 ± 0.8) cm, P < 0.01]. Within 48 hours, C-reactive protein (CRP) levels plummeted by over 50%, and bowel sounds normalized within 2 - 5 days. During surgery, the bowel exhibited only slight or negligible dilation and edema, with no conspicuous fecal residues detected in the colonic cavity. Furthermore, no severe tube-related adverse events occurred either during or after intubation.ConclusionThe application of deeply inserted enema tubes proves to be both feasible and safe in treating acute malignant left-hemicolon obstruction, thus presenting itself as a viable alternative approach in developing countries.https://www.frontiersin.org/articles/10.3389/fonc.2025.1522138/fulltubeendoscopymalignant obstructioncolorectal cancerleft hemicolon
spellingShingle Xinxiang Huang
Lijuan Zheng
Huifeng Wu
Xiaomei Li
Xiaomei Li
Conghua Song
The feasibility and safety of deeply inserted enema tubes for acute malignant left-hemicolon obstruction: an alternative solution in developing countries
Frontiers in Oncology
tube
endoscopy
malignant obstruction
colorectal cancer
left hemicolon
title The feasibility and safety of deeply inserted enema tubes for acute malignant left-hemicolon obstruction: an alternative solution in developing countries
title_full The feasibility and safety of deeply inserted enema tubes for acute malignant left-hemicolon obstruction: an alternative solution in developing countries
title_fullStr The feasibility and safety of deeply inserted enema tubes for acute malignant left-hemicolon obstruction: an alternative solution in developing countries
title_full_unstemmed The feasibility and safety of deeply inserted enema tubes for acute malignant left-hemicolon obstruction: an alternative solution in developing countries
title_short The feasibility and safety of deeply inserted enema tubes for acute malignant left-hemicolon obstruction: an alternative solution in developing countries
title_sort feasibility and safety of deeply inserted enema tubes for acute malignant left hemicolon obstruction an alternative solution in developing countries
topic tube
endoscopy
malignant obstruction
colorectal cancer
left hemicolon
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1522138/full
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