Application of para-anastomotic shunt stoma in emergency primary resection and entero-anastomosis of left-side obstructive colon cancer
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R735.35

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Supported by National Natural Science Foundation of China (81773049, 81402359), Shanghai Outstanding Young Specialist Physician Training (2017), and "Qihang" Talent Training Project of "Shenlan" Talent Program of Naval Medical University (Second Military Medical University) (2021)

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    Abstract:

    ObjectiveTo investigate the application effect of para-anastomotic shunt stoma in emergency primary resection and entero-anastomosis of left-side obstructive colon cancer.MethodsThe clinical data of 5 patients with left-side obstructive colon cancer who did not meet the endoscopic treatment condition or underwent failed endoscopic treatment in our hospital from Jul. 2019 to Jan. 2022 were analyzed retrospectively. All 5 patients underwent primary resection and entero-anastomosis+para-anastomotic shunt stoma and secondary colostomy closure operation. After the routine transection of the left-side colon, the resected colon specimen was removed; the distal colon port was anastomosed with the proximal colon lateral wall with a circular stapler; the proximal colon opening was pulled out through the original surgical incision or another incision to perform transabdominal wall single-lumen stoma. Stoma closure was completed by removing the colostomy segment with a linear incision closure device 4-8 weeks after the primary operation.ResultsAmong the 5 patients, there were 3 males and 2 females, aged from 37 to 71 years old, with an average age of 56.4 years old. The tumor was located in the splenic curvature of colon in 3 cases, in the middle part of descending colon in 1 case, and in sigmoid colon in 1 case. No anastomotic fistula, abdominal infection, or stoma-related complications occurred in the 5 patients after the primary tumor resection and entero-anastomosis+para-anastomotic shunt stoma. All the secondary stoma closure operations were successful, and there were no complications such as intestinal fistula or incision infection.ConclusionPara-anastomotic shunt stoma is effective, minimally invasive, and easy to operate in emergency primary resection and entero-anastomosis of left-side obstructive colon cancer. It is worth popularizing in clinic.

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History
  • Received:January 31,2022
  • Revised:April 15,2022
  • Adopted:
  • Online: October 19,2022
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