Endoscopy options in diagnostics and treatment of neoplastic colic obstruction
Abstract
Aim of investigation. To improve results of treatment of patients with colorectal cancer complicated by obstruction, by application of preoperative endoscopic recanalization of constrictive tumor.
Stuff and methods. Original study was carried out on 22 patients with the left-sided colorectal cancer complicated by ileus. Mean age of patients – 65 years. Duration of disorder was on average 3 days. In the study original method of endoscopic recanalization of large intestine tumor complicated by obstruction was applied. Complete recanalization was considered to be achieved if it was possible to pass by endoscope above tumor narrowing and at complete emptying of large intestine. If emptying of large intestine was temporal and it was not possible to achieve complete passage of stool and gases through created canal in tumor, manipulation was assessed as incomplete recanalization of tumor. Duration of procedure was on the average 2,5 h.
Results. Complete recanalization of tumor has been achieved in 9 (41%) patients, incomplete – at 5 (23%) and in 8 cases (36%) procedure was ineffective. Complications developed in 2 patients (9%). After endoscopic tumor recanalization 21 patient (one patient has refused from operation) has been operated. The lateterm interventions were carried out in 2 hs (at ineffective recanalization) up to 6 days (at complete recanalization). Operative treatment is completed by primary colic anastomosis in 11 (52%) patients, colostoma – in 10 (48%) patients. Postoperative complications developed in 2 (10%) patients, one patient died (5%).
Conclusion. Endoscopic recanalization of large intestinal tumor complicated by acute ileus, allows to eliminate acute ileus in majority of cases (64%) and so to suspend immediate surgery that enables high-grade preoperative preparation of the patient. The deferred surgical intervention allows to impose a primary colic anastomosis in most of the cases (52%).
About the Authors
M. I. Kuzmin-KrutetskyRussian Federation
A. M. Belyayev
Russian Federation
D. B. Degterev
Russian Federation
S. Yu. Dvoretsky
Russian Federation
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Review
For citations:
Kuzmin-Krutetsky M.I., Belyayev A.M., Degterev D.B., Dvoretsky S.Yu. Endoscopy options in diagnostics and treatment of neoplastic colic obstruction. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2008;18(3):73-76. (In Russ.)
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