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Transanal endoscopic tube decompression of acute colonic obstruction: experience with 51 cases

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Abstract

Background

Acute colorectal obstruction is a potentially life-threatening emergency that requires immediate surgical treatment. To avoid major postoperative complications, most surgeons advocate two-step surgery despite the increase in patient discomfort and cost. Various methods for performing one-step surgery have been reported including intraoperative colonic lavage, decompression with self-expandable metal stents, and transanal tube decompression.

Methods

The authors present their experience performing transanal colonic decompression for 51 patients.

Results

Endoscopic tube placement was successful for 43 (84%) of the 51 patients. The emergency clinical situation could be converted to semielective treatment in 37 cases (73%) (30 operations and 6 nonoperative interventions), and to an elective operation in 1 case. After successful colonic decompression, the rate of one-stage operations was 93% (28/30), as compared with 40% (4/10) if the decompression failed.

Conclusion

Endoscopic tube decompression of acute colonic obstruction is an easy and cost-effective possibility for avoiding emergency operations with all their sequelae. Emergency surgery can be converted to semielective or elective surgery, markedly reducing the rate of staged operations.

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Authors and Affiliations

  1. Department of General and Visceral Surgery, Albert-Ludwigs-University, Hugstetterstrasse 55, 79106, Freiburg, Germany

    A. Fischer, H. J. Schrag, M. Goos, R. Obermaier, U. T. Hopt & P. K. Baier

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  1. A. Fischer
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  2. H. J. Schrag
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Correspondence to A. Fischer.

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Fischer, A., Schrag, H.J., Goos, M. et al. Transanal endoscopic tube decompression of acute colonic obstruction: experience with 51 cases. Surg Endosc 22, 683–688 (2008). https://doi.org/10.1007/s00464-007-9461-z

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