ERKAN DALBAŞI, ABİDİN TÜZÜN, CEMALETTİN DURGUN, ABDULLAH OĞUZ
Turkish Journal of Colorectal Disease - 2023;33(2):31-35
Aim: The operation of choice for obstructed carcinoma of the left-side colon with perforation on the cecum is controversial. This study evaluated the timing of subtotal/total colectomy in acutely obstructed carcinoma of the left-side colon with perforation on the cecum. Method: Twelve patients with cecal perforation due to obstructed left-side colon tumor were included in this study. The patients were evaluated for age, gender, application time, presence of systemic diseases, Acute Physiology and Chronic Health Evaluation II scores, primary tumor localization, tumor stage, type of surgical operation, Mannheim Peritonitis Index, morbidity, and mortality. Results: Seven adenocarcinomas were localized on the left colon, three were localized on the midsigmoid, and two were localized on the rectosigmoid junction. All patients had a massively distended colon with perforation on the cecum. Seven patients underwent subtotal colectomy, while five patients underwent total colectomy. After the resection, anastomosis was performed using a circular stapler. After anastomosis, loop ileostomy was performed on the right side of the abdomen for all patients for anastomosis safety. Conclusion: This study suggests that resection, anastomosis, and protective loop ileostomy are viable surgical alternatives, even in emergency conditions, if they can be performed together with decompression and peritoneal lavage in the surgical treatment of cecum perforation due to obstructed left colon tumors.
