Is total-subtotal colectomy and primary anastomosis a good treatment alternative in malignant obstructive lesions of the left colon?

BACKGROUND This study was designed in order to compare the effectiveness of subtotal-total colectomy with other surgical methods in the treatment of malignant obstructive lesions of the left colon. METHODS Patients admitting with symptoms of colonic obstruction and treated by emergency surgery in Konya Education and Research Hospital between 2004 and 2007 were enrolled. Patients were divided into three groups according to the surgical procedures (Group I: Hartmann procedure; Group II: resection + diverting ileostomy; Group III: total-subtotal colectomy). Related patient data were evaluated retrospectively. RESULTS The mean age of 62 patients was 64 (38-89) years. There were no significant differences between the groups with respect to gender, age, American Society of Anesthesiology scores, and tumor stages. There were no significant differences between the study groups in terms of operative duration, postoperative mortality, and five-year survival; however, the length of hospital stay and hospitalization costs were lower in Group III compared to the other groups. CONCLUSION We suggest that subtotal-total colectomy performed by experienced surgeons may be a good alternative to the other procedures.