Subtotal colectomy for obstructing carcinoma of the upper left colon

Summary and Conclusions

Application of the principle of immediate resection and ileocolostomy to tumors of the right portion of the colon and to tumors of the upper left portion of the colon, in suitable cases, provides an easy and safe convalescence.

Twelve patients with obstructing lesions of the upper left portion of the colon were treated by immediate subtotal colectomy and ileocolostomy. there was one postoperative death, due to an anastomotic leak which caused a tension pneumoperitoneum. This complication is so rare that it was considered worthy of a separate report which appeared in 1964.¹

During the period under review, two obstructing carcinomas of the sigmoid flexure were treated in a similar fashion by immediate subtotal colectomy and ileocolostomy. Both these patients have had a good result, but it is believed that with tumors situated so far distally as the sigmoid flexure, some of the advantages of this form of treatment are lost.

It remains to be seen whether the long-term period of survival has been improved by this method.