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. 大肠癌并急性结肠梗阻的处理. 中国实用外科杂志, 2000, 20(8):459-461.
4.	吴善水, 吴荣兴, 王文武. 合并肠梗阻的左半结肠癌一期切除吻合术41例. 中国中西医结合外科杂志, 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, Eryılmaz MA, Okuş 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.	张磊, 陈亚进, 商昌珍, 等. 左半结肠梗阻全结肠灌洗一期切除吻合术. 中华消化外科杂志, 2007, 6(5):392-393.
18.	杨昌平, 陈玉秀, 郭宏荣. 急诊左半结肠梗阻一期切除吻合. 中华胃肠外科杂志, 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. 术中结肠灌洗Ⅰ期治疗梗阻性左半结肠癌与常规手术临床对比研究. 南方医科大学学报, 2010, 30(3):605-607.
21.	王亚军, 李非, 方育, 等. 左半结肠癌肠梗阻术中排便一期切除吻合术的临床应用. 中华胃肠外科杂志, 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.	渠时学, 王雪晨, 刘继祥, 等. 自制可固定式结直肠双腔引流管应用于治疗左半结肠和直肠损伤的研究. 中国综合临床, 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. 大肠癌并急性结肠梗阻的处理. 中国实用外科杂志, 2000, 20(8):459-461.
4. 吴善水, 吴荣兴, 王文武. 合并肠梗阻的左半结肠癌一期切除吻合术41例. 中国中西医结合外科杂志, 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, Eryılmaz MA, Okuş 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. 张磊, 陈亚进, 商昌珍, 等. 左半结肠梗阻全结肠灌洗一期切除吻合术. 中华消化外科杂志, 2007, 6(5):392-393.
18. 杨昌平, 陈玉秀, 郭宏荣. 急诊左半结肠梗阻一期切除吻合. 中华胃肠外科杂志, 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. 术中结肠灌洗Ⅰ期治疗梗阻性左半结肠癌与常规手术临床对比研究. 南方医科大学学报, 2010, 30(3):605-607.
21. 王亚军, 李非, 方育, 等. 左半结肠癌肠梗阻术中排便一期切除吻合术的临床应用. 中华胃肠外科杂志, 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. 渠时学, 王雪晨, 刘继祥, 等. 自制可固定式结直肠双腔引流管应用于治疗左半结肠和直肠损伤的研究. 中国综合临床, 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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