Curative Management of Malignant Left-Sided Colorectal Obstruction
Left-sided malignant colonic obstruction remains a challenging surgical problem despite recent advances. We aim to provide a concise overview of the relevant surgical options for this condition in the curative setting. A literature search of MedLine, PubMed, and Embase was performed to elucidate the...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2019-04-01
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| Series: | World Journal of Colorectal Surgery |
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| Online Access: | https://journals.lww.com/10.4103/WJCS.WJCS_44_18 |
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| author | Wen-Shen Lee Joseph C. Kong Peter Carne Stephen Bell Satish K. Warrier |
| author_facet | Wen-Shen Lee Joseph C. Kong Peter Carne Stephen Bell Satish K. Warrier |
| author_sort | Wen-Shen Lee |
| collection | DOAJ |
| description | Left-sided malignant colonic obstruction remains a challenging surgical problem despite recent advances. We aim to provide a concise overview of the relevant surgical options for this condition in the curative setting. A literature search of MedLine, PubMed, and Embase was performed to elucidate the latest evidence in the management of malignant left-sided colorectal obstruction, focusing on the risks and benefits of each approach and the appropriate patient selection. Primary resection and anastomosis are the intervention of choice for low-risk patients in the curative setting. Delayed resection with a bridge to surgery should be considered in unwell patients requiring medical optimization. While stenting has gained popularity, the risk of stent perforation carries a poor prognosis and must be carefully considered. Hartmann's procedure should be considered in high-risk elderly patients. Subtotal colectomy is preferred over segmental colectomy when there is extensive proximal colon damage but results in more frequent bowel actions postoperatively. |
| format | Article |
| id | doaj-art-693e7fb66ad541f1bebb0dd30e370876 |
| institution | DOAJ |
| issn | 1941-8213 |
| language | English |
| publishDate | 2019-04-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | World Journal of Colorectal Surgery |
| spelling | doaj-art-693e7fb66ad541f1bebb0dd30e3708762025-08-20T03:13:43ZengWolters Kluwer Medknow PublicationsWorld Journal of Colorectal Surgery1941-82132019-04-0182353910.4103/WJCS.WJCS_44_18Curative Management of Malignant Left-Sided Colorectal ObstructionWen-Shen LeeJoseph C. KongPeter CarneStephen BellSatish K. WarrierLeft-sided malignant colonic obstruction remains a challenging surgical problem despite recent advances. We aim to provide a concise overview of the relevant surgical options for this condition in the curative setting. A literature search of MedLine, PubMed, and Embase was performed to elucidate the latest evidence in the management of malignant left-sided colorectal obstruction, focusing on the risks and benefits of each approach and the appropriate patient selection. Primary resection and anastomosis are the intervention of choice for low-risk patients in the curative setting. Delayed resection with a bridge to surgery should be considered in unwell patients requiring medical optimization. While stenting has gained popularity, the risk of stent perforation carries a poor prognosis and must be carefully considered. Hartmann's procedure should be considered in high-risk elderly patients. Subtotal colectomy is preferred over segmental colectomy when there is extensive proximal colon damage but results in more frequent bowel actions postoperatively.https://journals.lww.com/10.4103/WJCS.WJCS_44_18colectomycolorectal neoplasmscolostomyintestinal obstructionstents |
| spellingShingle | Wen-Shen Lee Joseph C. Kong Peter Carne Stephen Bell Satish K. Warrier Curative Management of Malignant Left-Sided Colorectal Obstruction World Journal of Colorectal Surgery colectomy colorectal neoplasms colostomy intestinal obstruction stents |
| title | Curative Management of Malignant Left-Sided Colorectal Obstruction |
| title_full | Curative Management of Malignant Left-Sided Colorectal Obstruction |
| title_fullStr | Curative Management of Malignant Left-Sided Colorectal Obstruction |
| title_full_unstemmed | Curative Management of Malignant Left-Sided Colorectal Obstruction |
| title_short | Curative Management of Malignant Left-Sided Colorectal Obstruction |
| title_sort | curative management of malignant left sided colorectal obstruction |
| topic | colectomy colorectal neoplasms colostomy intestinal obstruction stents |
| url | https://journals.lww.com/10.4103/WJCS.WJCS_44_18 |
| work_keys_str_mv | AT wenshenlee curativemanagementofmalignantleftsidedcolorectalobstruction AT josephckong curativemanagementofmalignantleftsidedcolorectalobstruction AT petercarne curativemanagementofmalignantleftsidedcolorectalobstruction AT stephenbell curativemanagementofmalignantleftsidedcolorectalobstruction AT satishkwarrier curativemanagementofmalignantleftsidedcolorectalobstruction |